Tourniquet paralysis with prolonged conduction block. An electro-physiological study.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to P Rudge.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Seven patients are described with hyperextension or flexion injury to the cervical cord. They illustrate the symptoms and signs previously associated with damage to the centre of the cord, in that weakness is greater in the upper limbs than the lower. We do not believe that the relative sparing of the legs can be accounted for on the basis that corticospinal fibres passing to the lumbar anterior horn cells lie laterally in the pyramidal tract, as has previously been suggested by Schneider, Cherry, and Pantek (1954) as there is no evidence that there is such lamination in man. Severe pain in the shoulders and arms was a major symptom in six of the patients, even in those with relatively minor injuries. The nature of this pain was initially often not recognized.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The clinical presentations and aetiologies of a series of 53 cases of bilateral vestibular failure (BVF) seen by the authors over a decade were evaluated by retrospective review of the medical records. Thirty-nine per cent of patients had associated neurological disease; 13% had a progressive cerebellar syndrome with disabling gait ataxia, abnormal eye movements and cerebellar atrophy on neuro-imaging. BVF was usually unsuspected. Nine per cent had cranial or peripheral neuropathies and in this group there was no abnormality of brain stem/cerebellar oculomotor function, but hearing loss was common. Eleven per cent revealed BVF and hearing loss secondary to meningitis, and 6% had other neurological disorders. Idiopathic BVF was found in 21% of cases, characterised by paroxysmal vertigo and/or oscillopsia, but no abnormal clinical signs. Gentamicin ototoxicity accounted for a further 17%, while autoimmune disease was present in 9% of patients. Otological or neoplastic disease was diagnosed in the remaining 13% of patients. It was concluded that neurological, audiological and ocular motor assessments allow the probable cause of BVF to be defined in approximately 80% of cases. A group of BVF related to autoimmune pathologies is reported for the first time, indicating the need for immunological screening. Idiopathic BVF may present with only minor visual or vestibular symptoms, while in patients with cerebellar degeneration, BVF may be unsuspected and, thus, underdiagnosed.
The pure tone audiograms of 44 multiple sclerosis (MS) and 44 matched neurological control patients were studied with a view to finding out whether demyelinating disease is associated with decreased acuity to pure tones. The results show that MS patients have essentially normal hearing but auditory acuity at some of the low frequencies was found to be significantly worse in the MS group compared to the control patients. No correlation was found between the affected frequencies and the patients' age, sex and duration of the disease. The differences in thresholds between the control and MS patients were confined to the 25 patients who had clinical evidence of brain stem lesions suggesting that the cause of the abnormality in thresholds is in the brain stem.
Fourteen patients with hereditary motor and sensory neuropathy (HMSN), 12 of Type I and 2 of Type II, were assessed for auditory dysfunction. Five patients complained of hearing loss and all had pure-tone audiograms outside the normal range, while one patient who did not complain of hearing impairment also had an abnormal pure-tone audiogram. Assessment of loudness function, speech audiometry and brainstem auditory evoked potentials (BAEP) suggested that the hearing loss was the result of VIII nerve dysfunction, a conclusion supported by the abnormality of the electrocochleogram (ECochG) in one patient.
A patient with one-and-a-half syndrome due to brainstem ischaemia is presented. The case emphasises the importance of attempting to establish the aetiology of this syndrome--in this case infarction secondary to spontaneous vertebralartery dissection--when making therapeutic decisions.