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

The sensitivity of the Median Nerve Stress Test (Stress Test) described by La Ban et al. and performed hyperextending for one minute the supinated wrist and the distal interphalangeal joint of the index finger and looking for pain in the proximal forearm was evaluated in 140 arms with Carpal Tunnel Syndrome confirmed electrophysiologically. The Stress Test was positive in 60 hands (42.8%), the Phalen's sign in 79 (56.4%) and the Tinel's sign in 59 (42.1%). Hypoaesthesia to pinprick in the distribution of the median nerve was found in 45 hands (32.1%) and weakness or hypotrophia of thenar eminence in 17 (12.1%). In spite of his low sensitivity, in some cases the Stress Test was the only clinical positive sign and, in addition to electrophysiological examination, may be helpful in clinical practice.
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PMID:Tethered median nerve stress test in the diagnosis of carpal tunnel syndrome. 1078 59

Neurolymphomatosis (NL) is characterized by lymphomatous infiltration of the peripheral nervous system. We report a case of neurolymphomatosis (NL) which was confirmed by sural nerve biopsy. Sural nerve specimen from a 49-year-old female patient with weakness of limbs was examined with routine histochemical and immunohistochemistry staining, in which the first antibodies against CD3, CD20, CD45, CD45RO and CD68 were used. Numerous T-lymphoma cells invaded in the adipose tissue of epineurium of sural nerve. The nerve biopsy showed marked axonal degeneration of myelinated fibers. The clinical and histopathologic findings confirmed the diagnosis of neurolymphomatosis.
Beijing Da Xue Xue Bao Yi Xue Ban 2005 Jun 18
PMID:[Neurolymphomatosis, a case report]. 1596 31

To report the clinical, radiological and neuropathological findings of a patient with rheumatoid meningitis. The patient was a 71-year-old Chinese man with a two-year history of rheumatoid arthritis and no other significant medical history, who presented to our hospital recurrent weakness of his left extremities, dysarthria and a continuous bilateral hand tremor. Cerebrospinal fluid (CSF) and serum examinations were normal apart from a mildly raised serum perinuclear antineutrophil cytoplasmic autoantibody (p-ANCA). Brain magnetic resonance imaging (MRI) showed leptomeningeal enhancement in both frontal and parietal lobes, in addition to several old white matter infarcts. Meningeal biopsy showed numerous infiltrating macrophages and lymphocytes within the leptomeninges. The patient responded clinically and radiologically to corticosteroid and cyclophosphamide therapy. The patient subsequently developed herpes zoster over his left chest as a complication of his immunosuppressive treatment. His cyclophosphamide was ceased and intravenous immunoglobulin (IVIG) therapy was commenced, with good clinical response to both the herpes zoster and meningitis. According to the result of the biopsy, aseptic meningitis was considered the MRI results and the patient's clinical history were given, and a diagnosis of rheumatoid meningitis was made. The patient was p-ANCA positive. Although there was no evidence for cerebral vasculitis on biopsy, it remains a possibility that the patient's recurrent minor cerebral infarcts visible on MRI were vasculitic in nature.
Beijing Da Xue Xue Bao Yi Xue Ban 2006 Jun 18
PMID:[Rheumatoid leptomeningitis: a case report and literature review]. 1677 82

Peripheral T cell lymphomas-unspecified (PTCL-U) is an uncommon malignant tumor, accounting for 5%-7% of non-Hodgkin's lymphoma. Clinical feature of a case of PTCL-U was investigated and the optimal treatment protocol was proposed. The clinical presentation of this case was progressing limbs weakness with sudden paralysis. Multiple superficial lymph nodes swelling and decreased sensation in all modalities below T10 level were found in physical examination. Bilateral leg paralysis (Grade 0/5) with high muscle tension, overactive knee reflex, bilateral Babinski sign (+) were present. Magnetic resonance imaging(MRI) showed the mass, which was around spinal cord located in T6-T8 vertebra canal, with intense enhancement after the administration of gadolinium diethylenetriamine penta-acetic acid. Abnormal signal in multiple centrum and accessories could also be found in MRI scan. Initial diagnosis was lymphoma, multiple systems involved. Laminectomy and epidural tumor resection were performed immediately. The dural sac was narrowed obviously by surrounding tumor. The result of pathological examination was PTCL-U. After operation, the level of pain sensation was descent, and touch sensation recovered. The patient received chemotherapy and his muscle strength was partly recovered in 4 months. Early diagnosis of peripheral T cell lymphomas-unspecified was difficult and easily misdiagnosed with poor prognosis. A review of literature showed central nervous system lesions occurred in advanced stage. However, the report of representation of intraspinal mass as initial symptom like the case was rare. For acute paraplegia, laminectomy and tumor resection should be performed as soon as possible. Regular radiotherapy and chemotherapy should be considered after operation. However, the value of local chemotherapy need to be further investigated.
Beijing Da Xue Xue Bao Yi Xue Ban 2007 Aug 18
PMID:[A case of peripheral T cell lymphomas-unspecified in vertebra canal]. 1765 55

Lymphoma is a systemic disease. It is not uncommon to be found involved in digestive or central nervous system. However, lymphoma involved in these two systems at the same time is rare. The clinical feature of a case of lymphoma with gastrointestinal bleeding and limbs weakness was investigated and the literature was reviewed. The patient came to our hospital with melena and hematemesis. She was diagnosed as gastric ulcer by gastroscopy and biopsy showed lymphoma. Two days after she came to hospital, the patient presented with progressing limbs weakness. Magnetic resonance imaging (MRI) showed irregular abnormal signals in T2-T4 vertebra, which was enhanced obviously. A strip abnormal signal could be seen in spinal cord and involved in neighboring centrum and ribbing. The lesion extended to paravertebral tissue. The final diagnosis was lymphoma involved in stomach and spinal cord. Diseases presented with both upper digestive tract bleeding and symptoms of central nervous system were rare, including malignancies, virus infection and some therapy. Lymphoma was one of the causes. On the other hand, spinal cord ischemia might occur after gastrointestinal bleeding. Thus, doctors should examine the patients carefully to diagnose these diseases.
Beijing Da Xue Xue Bao Yi Xue Ban 2007 Aug 18
PMID:[A case of upper gastrointestinal bleeding and paraplegia]. 1765 79

Delayed postoperative spinal epidural hematoma (DPSEH) is a rare and potentially devastating complication of laminoplasty, and cervical nerve root palsy occurs more frequently than DPSEH, especially with C5 nerve root palsy. The authors describe a case of DPSEH with C5 nerve root palsy that developed in a patient 3 days after he underwent laminoplasty. In this case, a 78-year-old man with a history that having taken Aspirin without the doctor's instruction for 5-6 years, he underwent cervical laminoplasty for mild myelopathy. On the 3rd postoperative day, he complained of weakness of his left upper extremity and could not raise his left arm. The symptom aggravated in the next few days. On the 9th postoperative day, there was an obvious motor deficit of both upper and lower extremities. Magnetic resonance imaging demonstrated abnormal signal characteristics consistent with a hematoma at levels C3-C4, compressing spinal cord. The clot was evacuated during emergency revision surgery, and the postoperative course after the operation was uneventful and the muscle strength was improved five days later. Therefore, the symptoms of DPSEH are not so typical that its possibility should be kept in mind. Sometimes a differential diagnosis should be made with C5 nerve root palsy which may only represent weakness of upper extremities. The authors recommend that magnetic resonance imaging is helpful for the diagnosis of DPSEH and a revision surgery should be taken as soon as possible once the hematoma causing the neurologic deterioration was confirmed.
Beijing Da Xue Xue Bao Yi Xue Ban 2007 Aug 18
PMID:[A case of delayed cervical epidural hematoma with C5 nerve root palsy after posterior cervical laminoplasty]. 1765 80

Here we report the clinical, radiological and neuropathological findings of a patient with tumor-like inflammatory demyelinating diseases of the central nervous system.The patient was a 51-year-old man with a four-month history of inflammatory pseudotumor and no other significant medical history, who presented to our hospital recurrent relapse numbness and weakness of his right extremities, dysarthria and memory deterioration. Brain magnetic resonance imaging(MRI) showed mass focal lesion in white matter of left parietal lobes. The biopsy showed numerous infiltrating macrophages and lymphocytes within the perivascular. The patient responded clinically to corticosteroid and intravenous immunoglobulin(IVIG) therapy. According to the results of the biopsy and the MRI , a diagnosis of inflammatory pseudotumor of the central nervous system was made. The vascular dysfunction may act in the pathogenesis of inflammatory pseudotumor of the central nervous system.
Beijing Da Xue Xue Bao Yi Xue Ban 2009 Oct 18
PMID:[Tumor-like inflammatory demyelinating diseases of the central nervous system with relapse onset: a case report and review]. 1982 80

Methylmalonic aciduria combined homocysteinemia can cause multisystemic damages, mainly involving central nervous system, while the peripheral nerves are rarely impaired. A 10-year-old boy complained of weakness of both lower extremities for 1 month. His past history showed mildly delay of intelligence as well as motor development. He had proteinuria when he was 3 years old and was diagnosed as epilepsy, which was controlled by sodium valproate when he was 8 years 6 months old. His physical examination showed attenuated bilateral knee jerk reflex, while the bilateral achilles tendon reflex was absent; the examination of sensation was normal and the bilateral Babinski sign was positive. The electromyography indicated injury of peripheral nerves. The elevated levels of urine methylmalonic aciduria and plasma homocysteinemia were consistent with the diagnosis of methylmalonic aciduria combined homocysteinemia. The pathogenic gene was confirmed as MMACHC, on which two pathogenic mutations (c.365A>T and c.609G>A) were detected. cblC defect was confirmed. He was treated by vitamin B12, calcium folinate, L-carnitine and betaine supplementation, and significant improvement was observed after 6 months. According to this case, we suggest that urinary organic acid analysis and plasma homocysteine should be performed in patients with unknown peripheral neuropathy, especially combined with multisystemic damages.Early diagnosis and treatment are important to improve the prognosis.
Beijing Da Xue Xue Bao Yi Xue Ban 2013 Apr 18
PMID:[Peripheral nervous impairment in a patient with methylmalonic aciduria combined with hyperhomocysteinemia]. 2359 56

Glutamate as an excitatory neurotransmitter in the central nervous system, participate in initiation and maintaining of sleep and wakefulness. The paper presents an overview of the research progress of glutamate in the regulation of sleep and wakefulness, especially focuses on its role in the brainstem, lateral hypothalamus and basal forebrain. Glutamate in the brain stem regulates the brain activity and maintains muscle tone during the wakefulness, as well as adjusts the electroencephalograph (EEG) in rapid eye movement phase and leads to muscle weakness. Glutamate in the lateral hypothalamus participates in the lateral hypothalamic arousal system by activating orexins neurons. The basal forebrain glutamatergic neurons take part in EEG synchronization and cause the decrease of sleep. Finally,The glutamatergic neurons of the cerebral cortex is not just a target of the arousal system, but itself contribute to regulation of arousal. Meantime, the glutamatergic neurons can regulate sleep stages through interaction with other types of neurons, which forms a complex sleep-wake regulation network in the brain. These indicate that the switches between different phases of sleep and wakefulness have different neuronal circuits.So we also reviewed the neuronal circuits and mechanisms that glutamate may be involved in. This review will help us to get a better understanding of the roles of glutamate in sleep and wakefulness.
Zhejiang Da Xue Xue Bao Yi Xue Ban 2013 Sep
PMID:[The roles of glutamate in sleep and wakefulness]. 2416 43

Idiopathic inflammatory myopathies(IIM) are a group of autoimmune diseases characterized by muscle inflammation and progressive weakness. Diagnosis of IIM relies on the combination of clinical manifestation, blood biochemical indicators, myositis specific antibodies, electromyogram and pathology of muscle. Classification criteria of IIM keeps developing, and different criteria has different value on clinical application. IIM may involve important organs such as skin, joint, cardiac muscle and lung, except for skeletal muscle. Internal organs involvement should be evaluated and predicted, which could help to improve the prognosis of IIM. It is necessary to evaluate the disease activity objectively and accurately, which now could be accomplished with uniform and standardized clinical assessment system established by international organizations as the International Myositis Assessment and Clinical Studies Group. The immune pathological progress of IIM has already been well-known but the pathogenesis mechanism needs further study. Comprehensive evaluation of disease activity and organ damage need be emphasized before the beginning of treatments. Treatment strategies should be individualized, and the side effects of therapeutic drugs should be monitored. Multidisciplinary collaboration contributes to the improvement of diagnosis and therapy for IIM.
Sichuan Da Xue Xue Bao Yi Xue Ban 2013 Sep
PMID:[Comprehensive understanding and study on idiopathic inflammatory myopathies to improve its diagnosis and treatment]. 2432 14


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