A reversible paralytic syndrome with anti-GD1b antibodies following influenza immunization.
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Antibodies, Anti-Idiotypic↗
Biomedical subjects
M J Giuliani
Publications and source records attributed to M J Giuliani.
Cerebrovascular disease in women.
Cerebrovascular disease is one of the leading causes of death in women in the United States. Pregnancy and hormonal therapy have been associated with an increased risk of stroke in young women. Other conditions, more common in women, such as migraine headaches, rheumatologic disorders and antiphospholipid antibodies predispose women to cerebral ischemia. Women may also respond differently to antiplatelet therapy. The identification and treatment of such conditions will improve outcome in women with stroke and may prevent recurrent cerebrovascular events.
Cerebrovascular Disorders↗
Variations in dorsomedial hand innervation. Electrodiagnostic implications.
Sensory potentials recorded from the dorsal cutaneous branch of the ulnar nerve (DCUN) help localize ulnar nerve lesions. This conduction technique was first described by Jabre in 1980. Abnormalities detected with this technique in control populations are commonly attributed to local trauma. Anatomic variations of cutaneous innervation to the dorsum of the hand, however, have been described. We recorded DCUN responses using both the normal DCUN stimulation point and a secondary site of stimulation at the radial aspect of the forearm in 44 patients. Eleven patients demonstrated a low-amplitude DCUN response. Four of the 11 patients demonstrated sensory potentials obtained from the routine recording site of the DCUN with radial stimulation. We conclude that an abnormal DCUN response may represent anomalous innervation. To avoid some errors in localization, radial forearm stimulation should be performed whenever the DCUN response is abnormal.
Adult↗
Use of the pharyngeal flap with temporalis muscle for reconstruction of the unrepaired adult palatal cleft: report of two cases.
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Aged↗
Necrotizing angiopathy presenting with multifocal conduction blocks.
We describe conduction block as an unusual electrophysiologic manifestation in a patient with necrotizing angiopathy. The patient developed subacute symptoms over a 1-month period consisting of progressive pain, tingling, and weakness of the lower extremities. Physical examination revealed a pattern consistent with a polyneuropathy. Electrodiagnostic studies provided evidence of a conduction block in the left ulnar nerve. Pathologic studies confirmed the process to be a necrotizing angiopathy. This report establishes the role of conduction block in human nerve ischemia.
Electrodiagnosis↗
Cerebrovascular disease and stroke in women.
There are many special conditions which may predispose women to have a higher risk of stroke. These conditions include pregnancy and the puerperium, exogenous estrogen use, cerebral vasculitis, mitral valve prolapse and migraine. Recognition that certain stroke syndromes are more likely to affect women may aid the clinician in determining the optimal management of cerebrovascular disease and stroke in women.
Cerebrovascular Disorders↗
Neurologic recovery and functional improvement after vecuronium-induced quadriparesis.
Vecuronium bromide (Norcuron, Organon, Inc., West Orange, NJ) is a common neuromuscular blocking agent used to facilitate mechanical ventilation. Cases have been reported in which prolonged use of vecuronium resulted in severe motor neuropathy, with or without myopathy. However, the time course of recovery, the functional prognosis, and the use of inpatient rehabilitation is not well-established. We are reporting the functional recovery of two cases with the diagnosis of severe vecuronium motor neuropathy and/or myopathy. The patients presented with pneumonia and meningococcemia, respectively, and received vecuronium during ventilatory support, which lead to quadriparesis. In one patient, vecuronium toxicity occurred while neuromuscular junction monitoring was in place. Significant improvement was noted during an average of 3 to 4 wk in a comprehensive inpatient rehabilitation program, documented by the improvement in total motor Functional Independence Measure scores for patient 1 (from 15 to 71) and for patient 2 (from 65 to 84). In addition, the distal compound motor amplitudes showed a 4-fold increase for the ulnar, a 7-fold increase for the median, an 11-fold increase for the peroneal, and a 3-fold increase for the tibial nerves on follow-up nerve conduction studies correlating with neurologic recovery. In summary, even when patients present with quadriparesis, the recovery after vecuronium toxicity appears to be favorable.
Activities of Daily Living↗