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 52-year-old female complained of lumbago and weakness in the lower extremities 6 days after craniotomy for clipping an aneurysm. Neurological examination revealed symptoms consistent with lumbosacral cauda equina compression. The symptoms affecting the lower extremities spontaneously disappeared within 3 days. Magnetic resonance (MR) imaging 10 days after the operation demonstrated a lumbar spinal subdural hematoma (SSH). She had no risk factor for bleeding at this site, the symptoms appeared after she began to walk, and MR imaging suggested the SSH was subacute. Therefore, the SSH was probably due to downward movement of blood from the cranial subdural space under the influence of gravity. SSH as a complication of cranial surgery is rare, but should be considered if a patient develops symptoms consistent with a lumbar SSH after craniotomy.
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PMID:Lumbar spinal subdural hematoma following craniotomy--case report. 1035 85

A total of 41 patients who had undergone percutaneous nucleotomy for a single level lumbar disc herniation were clinically examined after a mean postoperative follow-up of 5 years (range 4 to 7 years). There were 14 (34%) male and 27 (66%) female patients with a mean age of 49 years. By intra-operative discography, the herniation had been graded as a protrusion in 21 (51%) patients and as a prolapse in 20 (49%) patients. At the time of the investigation, sciatica had completely recovered or markedly diminished in 32 (78%) patients, and 29 (71%) patients had returned to work. Evaluated by a 100 mm visual analog pain scale (VAS), the postoperative pain relief was statistically significant (p < 0.0001). Clinical signs and symptoms of segmental instability of the lumbar spine were detected in 10 (24%) patients. Instability was significantly associated with an unsatisfactory long-term outcome in the patients with the occurrence of sciatica (p = 0.003) and low back pain (p = 0.001) as well as the VAS score (p = 0.005) and Oswestry index (p < 0.0001). Clinical investigation revealed sensory deficits in the leg in 12 (29%) patients, weakness of the extensor hallucis longus muscle in 5 (12%) patients and a total peroneal paresis in one (2%). The patellar and achilles tendon reflexes were depressed in 2 (5%) and 5 (12%) patients, respectively. During the follow-up period, recurrent disc herniation was detected in 3 (7%) patients who were all re-operated on. In addition, 3 (7%) patients were re-operated on for other back problems. Corroborating earlier findings, the results of this study indicate that percutaneous nucleotomy is an effective and safe alternative to open surgery in the treatment of patients with a small prolapse or a protrusion.
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PMID:Long-term outcome of patients who underwent percutaneous nucleotomy for lumbar disc herniation: results after a mean follow-up of 5 years. 1039 88

Based on musculoskeletal anatomy of the lower back, abdominal wall, pelvis and upper legs, a biomechanical model has been developed on forces in the load transfer through the pelvis. The aim of this model is to obtain a tool for analyzing the relations between forces in muscles, ligaments and joints in the transfer of gravitational and external load from the upper body via the sacroiliac joints to the legs in normal situations and pathology. The study of the relation between muscle coordination patterns and forces in pelvic structures, in particular the sacroiliac joints, is relevant for a better understanding of the aetiology of low back pain and pelvic pain. The model comprises 94 muscle parts, 6 ligaments and 6 joints. It enables the calculation of forces in pelvic structures in various postures. The calculations are based on a linear/non-linear optimization scheme. To gain a better understanding of the function of individual muscles and ligaments, deviant properties of these structures can be preset. The model is validated by comparing calculations with EMG data from the literature. For agonistic muscles, good agreement is found between model calculations and EMG data. Antagonistic muscle activity is underestimated by the model. Imposed activity of modelled antagonistic muscles has a minor effect on the mutual proportions of agonistic muscle activities. Simulation of asymmetric muscle weakness shows higher activity of especially abdominal muscles.
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PMID:A biomechanical model on muscle forces in the transfer of spinal load to the pelvis and legs. 1046 Jan 29

We herein report a case of spinal myoclonus following the administration of epidural anesthesia. A 25-year-old woman underwent lumbar epidural anesthesia because of lumbago and cramps in her left lower limb. She immediately felt a lancinating pain in her left limb during anesthesia at the level of L 4/5 and soon developed myoclonus in her left thigh. The neurological examination revealed rhythmic myoclonus in the left quadriceps and adductor thigh muscles. The myoclonus disappeared after performing a blockade of the left L 4 spinal root by using 1.5 ml of 1% lidocaine. An injury to the left L 4 nerve root during the epidural anesthesia possibly caused an abnormal transmission of the impulses or ectopic hyperexcitability in the nerve root, which might lead to the disturbance of the spinal inhibitory interneurons and hyperexcitability of the anterior horn cells causing myoclonus. Since she did not demonstrate any muscular weakness, nor sensory loss during the lidocaine block, the 1% lidocaine appeared to block the sympathetic nerves or to suppress the ectopic hyperexcitability. The sympathetic nerves may be involved in the development of her spinal myoclonus.
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PMID:[A case of spinal myoclonus associated with epidural block for lumbago]. 1050 93

A 66-year-old man who underwent a total gastrectomy 13 years ago was admitted to our hospital complaining of severe low back pain and muscle weakness. Biochemical examinations revealed hypocalcemia, hypophosphathemia, low serum 25 (OH) vitamin D and hyperparathyroidism. A chest CT scan revealed pseudofractured ribs, whereas plain X-photography did not show any significant findings. We diagnosed the illness as osteomalacia due to malabsorption. The patient has been receiving oral active vitamin D and calcium, and the pain and serum calcium and phosphate values have improved to the point that he can receive out-patient treatment.
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PMID:Osteomalacia that became symptomatic 13 years after a total gastrectomy. 1083 Jan 80

A 56-year-old female presented with mild low back pain. Examination revealed severe, selective atrophy of the thoracic and lumbar paraspinal muscles. Fibrillations were seen in the paraspinal muscles on EMG. Limb EMG was normal. Biopsy of the gluteus maximus was normal. Paraspinal muscle biopsy revealed neurogenic features. Atrophy of the thoracic and lumbar paraspinal muscles was noted on magnetic resonance imaging. This patient has selective amyotrophy of the thoracic and lumbar paraspinal muscles. This may be an addition to the spectrum of 'benign focal amyotrophy'. The differential diagnosis of paraspinal muscle weakness is discussed.
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PMID:Selective paraspinal muscle amyotrophy. 1086 95

In the field of lumbar spine disorders, three-dimensional (3-D) magnetic resonance imaging (MRI) can clearly depict a lumbar nerve root from the distal region to the dorsal root ganglion. In this study, we used a gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) enhanced-three-dimensional (3-D) fast low-angle shot (FLASH) sequence when examining lumbosacral disorders. The subjects were 33 patients (14 men and 19 women) in whom lumbosacral neural compression had been diagnosed clinically. Twenty-one patients had lumbar disc herniation, 11 had lumbar spinal stenosis, and 1 had lumbar radiculopathy caused by rheumatoid arthritis. Five subjects with low back pain were also studied as a control group. In all patients and in all 5 of the controls, the dorsal root ganglion of every root was enhanced clearly. There was no root enhancement in the 5 controls. Enhancement of the symptomatic nerve roots, caused by compression, was found in 11 of the 33 patients. All 11 patients had radiculopathy, and muscle weakness was more frequent in patients with enhanced nerve roots than in those without enhancement. There was no enhancement of the cauda equina, even in the patients with cauda syndrome. The enhancement effect may reflect some pathological condition of the compressed nerve root and needs to be studied further.
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PMID:The role of Gd-enhanced three-dimensional MRI fast low-angle shot (FLASH) in the evaluation of symptomatic lumbosacral nerve roots. 1148 93

A 53-year-old woman experienced progressive general weakness and lumbago in the 2 years prior to a physical examination which disclosed cushingoid manifestations and a skin ulcer on the back of her right knee joint. Her plasma cortisol concentration ranged from 24.7 to 31.1 microg/dl, with an ACTH level <5 pg/ml. Urinary excretions of 17-hydroxycorticosteroid (17-OHCS) and 17-ketosteroid (17-KS) were 20.5 mg/day and 5.1 mg/day, respectively, and urinary cortisol was also increased (421 microg/day). Cortisol was not suppressed after the administration of 8 mg dexamethasone. Abdominal ultrasound sonography, computed tomography (CT) scan, and magnetic resonance imaging (MRI) studies demonstrated a left adrenal tumor and further, a chest X-ray examination showed a cavitary lesion containing a fungus ball-like mass in the left lower lung field. The serum cryptococcal antigen titer was positive at 1:128 and a bronchoalveolar lavage fluid culture yielded a growth of Cryptococcus neoformans. A biopsy specimen of the skin ulcer also suggested cryptococcosis. As a result, a left adrenectomy was performed, and the excised specimen was shown to be an adenoma consisting of compact cells with abundant pigmentation (black adenoma). A diagnosis of functioning black adenoma of the adrenal gland, complicated with pulmonary and cutaneous cryptococcosis was made.
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PMID:Functioning adrenal black adenoma with pulmonary and cutaneous cryptococcosis: a case report and review of English literature. 1176 53

Multiple arteriovenous fistulas (AVFs) of the spine are rare. The authors reported a case of spinal AVFs occurring at two separate sites including the conus medullaris and the dura of the sacral region. A 31-year-old man had a two-week history of progressive low back pain, mild gait disturbance and dysuria. Examination revealed mild motor weakness of both legs, disturbance of superficial sensibility below the L4 dermatome on both sides and dysuria. Sensory disturbance was most obvious in the perianal region, although deep sensibility was not disturbed. Magnetic resonance images (MRIs) of the spine showed many serpentine flow void signals from the lower thoracic region to the sacral region, and spinal arteriovenous malformations were suspected. Selective spinal angiography revealed two AVFs at the separate sites including intradural perimedullary AVF at the conus medullaris and dural AVF at the sacral region. The dural AVF of the sacral region was fed by the left lateral sacral artery and drained through the dilated coronal venous plexus to Th11 level. Embolization with N-butylcyanoacrylate (NBCA) was performed using an endovascular procedure for both AVFs. Although recanalization of the dural AVF of the sacral region was confirmed by angiography two weeks later, it was treated successfully by the surgical approach.
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PMID:[Multiple spinal arteriovenous fistulas occurring at conus medullaris and dura of the sacral region: a case report]. 1179 50

A 57-year-old male with prostatic cancer was scheduled for a radical prostatectomy under general anesthesia combined with epidural anesthesia. An epidural catheter was introduced at the L 1-2 interspace without problem. The patient was placed in a hyperlordotic supine position with a bolster under his lower back for the seven and a half hour operation. Upon emergence from anesthesia, he complained of severe low back pain in addition to incisional pain. On the second postoperative day, the epidural catheter was removed. After residural analgesic effects had fully disappeared, he experienced muscular weakness in the left thigh and could not walk. Regional sensory loss and edema were also observed where pressure had been applied by the bolster, although spinal cord magnetic resonance imaging studies were almost normal. It took him seven weeks to walk without the support of a brace after surgery. Hyperextension of the lumbar spine could increase the pressure on the inferior vena cava which is transmitted to the intraspinal vein, and could lead to the disci intervertebrales compression and the stress on the facet joint. We believe that the primary cause of the presented symptoms was related to this position. Prolonged and/or excessive hyperlordosis during surgery should be avoided.
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PMID:[Severe low back pain and muscular weakness in the thigh following urological surgery in the hyperlordotic position]. 1184 Jun 67


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