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Query: UMLS:C1762617 (weakness)
 37,932 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This case report presents a patient who developed right shoulder pain following strenuous upper-extremity exercise. Approximately 6 weeks later his pain resolved, he noticed persistent right upper-extremity weakness. He was referred to physical therapy for evaluation and treatment. Physical therapy evaluation revealed isolated serratus anterior muscle paralysis. A long thoracic neuropathy was subsequently confirmed by electromyographic testing. The etiology, pathophysiology, and pathokinesiology of serratus anterior muscle paralysis are reviewed. A case is presented, illustrating how the clinical decision making is based on the pathokinesiology and pathophysiology. The patient was followed over the course of 17 months and has recovered full right shoulder active range of motion. His serratus anterior muscle strength has increased to Good minus, and he reports significantly improved functional use of the upper extremity.
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PMID:Physical therapy management of isolated serratus anterior muscle paralysis. 787 Jul 51

Shoulder pain and dysfunction is a common problem among athletes, and a great deal of attention is being given to scapular stability and rotator cuff pathology. Two athletes who were first seen with posterolateral shoulder pain and weakness were found to have isolated entrapment of the suprascapular nerve, causing their impairment. Both athletes responded well to conservative treatment, but this entity occasionally requires operative decompression. This article reviews the most common presentation, etiologies, and treatments of suprascapular neuropathy and how it can affect athletic performance.
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PMID:Suprascapular neuropathy in athletes: case reports. 788 15

The etiology of shoulder pain in spinal cord injured (SCI) patients has been attributed to overuse, with dysfunction being more prevalent as the time since injury increases. Impingement syndrome, the most common diagnosis in this population, may be related to weakness of the rotator cuff and shoulder girdle musculature. Shoulder dysfunction is greater in subjects with SCI than in able-bodied patients; consequently, this study compares isometric strength of quadriplegic and paraplegic subjects to able-bodied controls. Peak isometric torque for internal rotation, external rotation, and scapular elevation was assessed using a Lido isokinetic dynamometer. The strength (torque) values of the quadriplegic group were significantly lower than the control group and paraplegic group for all motions tested (p < .0005). The only significant difference between the paraplegic and able-bodied groups was found with internal rotation (p < .0001). These results indicate that quadriplegic patients may be at greater risk for shoulder pathology because of both muscular limitation and increased functional demand.
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PMID:Isometric shoulder torque in subjects with spinal cord injury. 802 21

We report six patients with isolated paralysis of the infraspinatus and discuss the diagnosis, pathology, treatment, and outcome over a mean follow-up period of 33 months. Four patients were shown to have space-occupying lesions at the spinoglenoid notch by MRI or ultrasonography or both, and ganglia were confirmed and removed surgically in three, with good results. Ganglia at this site are not uncommon and should be included in the differential diagnosis of patients presenting with shoulder pain and weakness.
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PMID:Isolated paralysis of the infraspinatus muscle. 802 45

We describe five patients, seen since 1984, with posterior shoulder pain and isolated wasting and weakness of the infraspinatus. In four of these a ganglion in the spinoglenoid notch was demonstrated by MRI and in one recent case ultrasound scans were positive. Three patients have been treated by operation, but there was recurrence in one after five years. In each confirmed case, the ganglion straddled the base of the spine of the scapula, extending into both supraspinatus and infraspinatus fossae. The nerve was either compressed against the spine or stretched over the posterior aspect of the ganglion. Adequate surgical exposure is essential to preserve the nerve to the infraspinatus and to allow complete removal of the ganglion. This is difficult because of the location and thin-walled nature of the cysts.
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PMID:Infraspinatus paralysis due to spinoglenoid notch ganglion. 802 46

Infraclavicular nerve injuries are rare and potentially disabling problems. A retrospective study of 24 patients with 28 nerve injuries is presented, including 18 axillary, 7 suprascapular, and 3 musculocutaneous nerve injuries. Vague shoulder pain and weakness of the involved muscle groups were the main symptoms of nerve injury in these patients. All patients had atrophy of the specific muscles involved. Diagnosis of these nerve lesions can often be difficult because of this vague presentation. Followup from date of injury averaged 60 months and included evaluation by questionnaire, repeat physical examinations, and serial electromyograms. There were 21 complete or satisfactory nerve recoveries, while 7 patients had unsatisfactory results. The etiology of the injury appeared to be an important factor with respect to outcome. Eight of 10 nerve injuries secondary to blunt trauma went on to complete recovery, and 4 of 6 nerve injuries secondary to shoulder dislocation recovered completely. None of the 7 nerves injured during surgery recovered completely. No patient with spontaneous onset of nerve dysfunction had an unsatisfactory result. Poor results were noted in patients with initial total denervation as shown by electromyogram and in patients with intraoperative nerve damage.
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PMID:Isolated nerve injuries about the shoulder. 807 Feb 12

Suprascapular neuropathy may present with chronic shoulder pain and weakness of abduction and external rotation of the arm. Therefore, it should always be included in the differential diagnosis of shoulder pain. Usually, the nerve is compressed at the suprascapular notch or the spinoglenoid notch. Here, the nerve is relatively fixed. In the etiology, repeated and forceful movements around the shoulder joint, especially in athletes such as volleyball players, are considered to be frequent causes of suprascapular nerve damage, whereas ligament hypertrophy and ganglia are uncommon. If conservative therapy fails, surgical decompression of the nerve is required for relief of pain and resolution of weakness.
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PMID:[Differential diagnosis of shoulder pain: chronic neuropathy of the suprascapular nerve]. 821 5

Functional changes were assessed in a group of 279 individuals with long-term spinal cord injuries. All had sustained their initial injuries 20 to 47 years ago and all had received initial and postinjury follow-up care at one of two British spinal cord injury treatment centers. Twenty-two percent reported that the need for physical assistance from others had increased over the years. Most (45%) needed additional help with transfers; others needed more assistance with dressing, mobility, and toileting. When compared to those whose need for help had not increased, significant differences were found by age: as a group, and when separated by level and severity of injury, those needing more help were older, and those with cervical injuries needed help at younger ages than their counterparts with lower level injuries. Those needing more help also had significantly more reports of shoulder pain, fatigue and weakness, weight gain, and postural changes. They used more attendant care, and perceived their quality of life to be lower than those whose level of function had not changed over time.
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PMID:Long-term spinal cord injury: functional changes over time. 821 52

A 41-year-old woman had radical mastectomy for breast cancer with metastasis of axial lymph nodes three years previously. In February 1990, she noticed swelling of lymph nodes in right suparclavicular region. A lymph node biopsy revealed cancer cells. Immediately, radiation therapy was performed. However, in August serum levels of CA 15-3 and LDH were markedly elevated. Two months later the patient complained of severe headache, dysarthria, shoulder pain and anorexia. Neurological examination revealed stiff neck, weakness of bilateral facial muscles, deviation of tongue to the left and no sensory disturbance. A CSF sample by lumbar puncture showed 26/mm3 in cell counts, 204 mg/dl of protein and 11 mg/dl of glucose. In addition, CSF cytology revealed malignant cells four to five times as large as lymphocytes. Immediately, and intrathecal administration of methotrexate (MTX) was started. However, one week later she developed complete paraplegia with sensory disturbance below the L1 levels and an incontinentia urine. CSF examination performed again, and showed 97/mm3 in cell counts, 792 mg/dl of protein and 91 mg/dl of glucose. On October 10, a CT scan of the head showed contrast enhancement along cerebellar folia and narrowing of quadrigeminal cistern. On November 31, sagittal T1W1 with Gadolinium revealed an enhancing stripes along the spinal cord at the Th10 to L4 levels. This finding was suggested to be meningeal carcinomatosis. On December 8, she died. At autopsy, brownish hemorrhagic mass was noticed in the bilateral cerebellar tonsils, and severe downward displacement of the tonsils.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of meningeal carcinomatosis showing myelopathy--detection of TNF-alpha in infiltrating CSF cells and brain tissue sections of cerebellum]. 831 90

A 26-year-old woman had the right shoulder pain, weakness in her right arm, and noticed coldness in her right arm when it is down. On examination, she had droopy shoulder dominantly in right side, weakness and paresthesia in her right upper limb in the distribution of C8-Th1. The thoracic outlet compression tests were positive in her right side. Angiography of the right subclavian artery and brachial plexography under Allen's position revealed compression at the thoracic outlet. A cervical MRI revealed localized atrophy of the spinal cord (right side dominant) at the level of C5-6 vertebral body. Her spinal cord and dural sac moved anteriorly in cervical flexion. Droopy shoulder may be a risk factor of thoracic outlet syndrome and also flexion myelopathy. Double crush nerve compression of lower motor neuron at anterior horn of the cord and at the thoracic outlet may have accelerated the symptoms.
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PMID:[A case of flexion myelopathy with thoracic outlet syndrome]. 833 2


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