Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Muscular weakness”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMed1993

[Scleromyxedema associated with myopathy].

We describe a 45 year-old man, with scleromyxedema associated to systemic manifestations, including myopathy. After 6 years of dermatologic manifestations, muscular weakness, with proximal predominance resulting in incapacity, was established. Corticosteroids plus cyclophosphamide treatment suppressed muscular symptomatology, and a second biopsy was normal. The common association between scleromyxedema and myopathy and other systemic alterations suggest that this entity should probably be considered as a systemic disease instead as a skin disease.

Cyclophosphamide↗
PubMed1988

[Neuromuscular forms of hyperparathyroidism. Apropos of 2 cases].

The authors report two cases of hyperparathyroidism presenting mainly with muscular weakness. In the first case, a 74 year old woman had become completely bed-ridden and muscular recovery was obtained in 18 months. In the second case, a 24 year old sportsman had to stop all competition. Hypercalcaemia was suspected after finding radiological muscular calcification; the patient was able to start his sporting activities again two months after excision of the adenoma. After a review of the literature the authors discuss the principal physiopathogenic mechanisms; a direct action of parathormone is the probable cause but this has not been proved. Muscular forms of hyperparathyroidism are rare but this "pseudo-myopathic" presentation justifies the systematic exclusion of hyperparathyroidism in all cases of unexplained muscle weakness.

Adolescent↗
PubMed2002

[Diaphragmatic weakness in sepsis: the role of oxidant stress].

In sepsis contractile weakness of the diaphragm is a major cause of the onset of respiratory failure. This muscular weakness is the result of haemodynamic and metabolic disorders secondary to sepsis and also the damaging effects of inflammatory mediators, among which oxygen free radicals play a crucial role. This role is demonstrated by the protective effect of various exogenous anti-oxidants on diaphragmatic contraction. Early in the course of sepsis there is, in animal models and in man, an increased production of oxygen free radicals and nitric oxide (NO) in the diaphragm, principally within the mitochondria. The formation of peroxinitrite as the result of the action of NO on superoxide anions impairs mitochondrial respiration and consequently the energy production necessary for diaphragmatic contraction. Among the endogenous anti-oxidant systems haem oxygenase, which splits haemoglobin into bilirubin, iron and carbon monoxide, is an effective system for the protection of diaphragmatic function by limiting the damage of oxidant stress. Nevertheless a transient deficiency of local anti-oxidant defences during the early stages of sepsis, when the production of oxygen free radicals is intense, encourages the onset of contractile weakness.

Animals↗
PubMed1991

[Charcot-Marie-Tooth disease associated with dilated cardiomyopathy: an autopsy case report].

This is a clinical report of a rare case of Charcot-Marie-Tooth disease associated with dilated cardiomyopathy. A seventy-seven-year-old Japanese male first visited our outpatient clinic with a ten-year history of muscular weakness in his bilateral lower extremities and gait disturbance characterized by classical features of peroneal muscular atrophy and inverted champagne bottle legs. Biopsy findings of the m. quadriceps femoris and the n. gastrocnemius revealed clustered atrophy of myofibrils and segmental demyelinization mingled with remyelinization. Because of his other problem of dilated cardiomyopathy, he had been treated with salt restriction, digitalis, diuretics and vasodilators, until his third hospitalization, when he developed terminal stage of severe congestive heart failure. Despite our intensive cardiac care, the patient died because of profound pump failure. Autopsy findings disclosed a remarkably dilated left ventricular chamber and an increased total heart weight of 600 grams. Grossly, the cross sectional view of the left ventricle revealed diffuse, but not homogenous fibrosis that was most prominent in the posterior wall. On light microscopic examination, the left ventricular myocardium revealed diffusely scattered muscular degeneration interlaced with fibrosis. Although large epicardial coronary arteries revealed only mild intimal atheromatous thickening, most of the small intramuscular coronary arteries were free from atherosclerosis. Neither diabetic nor amyloid lesions could be detected. It has been well known that cardiomyopathy is often associated with various forms of muscular dystrophy and Friedreich's ataxia.(ABSTRACT TRUNCATED AT 250 WORDS)

Atrophy↗
PubMed1993

[Is chronic dermato- or polymyositis misdiagnosed as "weakness of old age"?].

Two women, aged 72 (case 1) and 77 (case 2) were referred for neurological diagnosis because of progressive muscular weakness, for 4 and 18 months, respectively, which had finally led to dysphagia and required mechanical ventilation. The cause of the disease in case 1 was classical dermatomyositis. Creatinine kinase concentration, never previously measured, was 950 U/l. In case 2 there was polymyositis, previously not considered as she had a diabetic polyneuropathy and muscle enzyme concentration was normal. In both cases the correct diagnosis was speedily confirmed by electromyography and muscle biopsy. Immunosuppressive treatment was largely successful in reversing the symptoms (case 1: initially 500 mg methylprednisolone daily, reduced to 50 mg daily within 6 weeks; case 2: 500 mg methylprednisolone daily for 1 week, then 100 mg daily plus 150 mg azathioprine with maintenance dosage of 20 mg glucocorticoid daily).--These two cases demonstrate that, particularly in the elderly, dermatomyositis and polymyositis should be considered in the differential diagnosis of progressive general weakness.

Aged↗
PubMed2003

Abnormal kainic acid receptor density and reduced seizure susceptibility in dystrophin-deficient mdx mice.

Duchenne muscular dystrophy is characterized by a defect in dystrophin, which often causes mental retardation in addition to progressive muscular weakness. As dystrophin is localized in synaptic regions of the CNS, cognitive abnormalities associated with Duchenne muscular dystrophy are attributable to synaptic dysfunction. We report that dystrophin-deficient mdx mice were more resistant to kainic acid-induced seizures but not to GABA antagonist-induced seizures compared with the control mice. The kainic-acid receptor density in the brain was significantly lower in the mdx than in the control, although the density of muscarinic cholinergic receptors, another important neurotransmitter receptor for cognitive function, was normal. Moreover, mdx had significantly lower Timm staining intensity in the mossy fibers, which originate from the dentate granule cells and terminate on the pyramidal cells in the CA3 of the hippocampus. These results suggest that an instability of neurotransmitter receptors, such as kainate-type glutamate receptors, on synaptic membranes due to the disruption of dystrophin complex induces inefficient neurotransmission in Duchenne muscular dystrophy patients.

Animals↗
PubMed1995

[A case of Guillain-Barré syndrome associated with anti-GM2 antibody due to cytomegalovirus infection--special reference to the effect of ganciclovir].

We report a case of Guillain-Barré syndrome (GBS) associated with anti-GM2 antibody caused by cytomegalovirus (CMV) infection. A 27-year-old man was admitted to our hospital because of muscle weakness in all his extremities. He had no background of immunological abnormalities. Within 5 days, generalized muscular weakness had progressed so rapidly that he suffered respiratory dysfunction and dysphagia. Throughout the entire clinical course, enzyme immunoassay (serum) and enzyme-linked immunosorbent assay (CSF) for CMV were carried out serially. Only antibodies against CMV were elevated during the clinical course in the serum and CSF. These findings supported the idea that he had developed GBS due to isolated CMV infection. We examined the reactivity of GBS sera with crude ganglioside fraction, and only anti-GM2 antibody was recognized on a high-performance thin-layer chromatogram plate in this case. Although the anti-GM2 antibody was decreased transiently by plasmapheresis, the clinical symptoms progressed. The symptoms advanced very rapidly during high-dose gammaglobulin therapy associated with reelevation of the anti-GM2 antibody. Following ganciclovir administration, however, the symptoms became diminished within 7 days and the anti-GM2 antibody fell dramatically. We speculate that the reason for the observed effectiveness of ganciclovir was direct suppression of activation of CMV, followed by the inhibition of the production of demyelinating antibodies including the anti-GM2 antibody.

Adult↗
PubMedDate not supplied

Charcot-Marie-Tooth syndrome and surgical management for left main coronary artery disease.

A 36-year-old male had coronary heart disease with a 12-year history of muscular weakness in his bilateral lower extremities and gait disturbance characterized by classical features of gastrocnemius and peroneal muscular atrophy. This is a clinical report of the first case of Charcot-Marie-Tooth disease (type 2) associated with the left main coronary artery disease requiring bypass surgery with cardiopulmonary bypass. The surgical procedure and postoperative course were uneventful. The patient was followed for 18 months postoperatively.

Adult↗
PubMed1979

Potentiation of neuromuscular weakness in infant botulism by aminoglycosides.

A retrospective study of ten patients with infant botulism who received gentamicin or kanamycin suggests that aminoglycoside antibiotics potentiate muscular weakness and precipitate respiratory failure as late as 27 days after onset of the disease. Although it is difficult to separate progression of the disease from the effects of antibiotics, the rapidity of deterioration following aminoglycoside treatment and the rapidity of recovery following cessation of aminoglycoside therapy is highly suggestive. A review of five patients who received only penicillin or a semisynthetic derivative of penicillin did not reveal any temporal deterioration with onset of penicillin therapy or improvement with cessation of penicillin therapy.

Ampicillin↗
PubMed1988

Electromyographic abnormalities in patients undergoing long-term therapy with etretinate.

Neuromuscular evaluation including electromyographic studies and serum muscle enzyme level determinations were performed in 13 patients who had been receiving etretinate for 1 to 2 1/2 years. None of the patients had complained of muscle pains or weakness. In 3 of 13 patients the electromyographic studies showed low amplitude and short duration action potentials. Mild muscular weakness was detected in one of these three. The levels of serum muscle enzymes were within the normal range in all patients. Results suggest that etretinate may cause subclinical muscle damage. In view of our results and previous reports, it seems that neuromuscular evaluation should be part of the routine follow-up of patients receiving long-term therapy with etretinate.

Action Potentials↗
PubMed1981

Centrally-generated commands and cardiovascular control in man.

It has long been established that neural activity generated wholly within the central nervous system can affect cardiovascular control. Even during complete paralysis the central cycling of respiratory neurones can impose respiratory rhythmicity on heart rate and vasomotion, and alter the effectiveness of purely cardiovascular reflexes. During muscular exercise centrally-generated voluntary motor command signals contribute to the stimulation of heart rate and the rise in blood pressure. This is seen, for example, when muscular weakness is induced by partial curarization, by fatigue, or by other means, so that a given level of muscular contraction is achieved only with an increased motor command, or 'effort'. Such command-related stimuli are essentially without cardiovascular feedback and are likely at most to provide coarse adjustments upon which finer controls are superimposed by well-known reflex mechanisms.

Cardiovascular System↗
PubMed1997

Scorpion sting in Zimbabwe.

OBJECTIVE: To describe the epidemiological and clinical features of scorpion stings in a district with potentially lethal scorpions. DESIGN: Case series of consecutive scorpion sting victims. SETTING: Manama Hospital and all seven rural health centres in Gwanda South District, Zimbabwe (population 62500). PARTICIPANTS: All known cases of scorpion sting reporting to health centres in the district; all severe cases in which the scorpions had been identified, and who were admitted and examined by the author between September 1991 and September 1993. MAIN OUTCOME MEASURES: Description of clinical features of severe Parabathus transvaalicus scorpionism. RESULTS: Two hundred and forty-four cases, of which 184 were P. transvaalicus Purcell, 1899. Seventeen patients with severe P. transvaalicus scorpionism showed sensory and motor nerve stimulation, with generalised hyperaesthesia, weakness, ptosis, dysphagia, muscle tremors and abnormal reflexes. There was cardiac involvement, and respiration was compromised secondary to muscular weakness. Parasympathetic nervous system stimulation was seen in the absence of sympathetic stimulation, with profuse sialorrhoea, sweating and urinary retention. CONCLUSIONS: The clinical features of P. transvaalicus scorpionism are described for the first time. These resemble those of P. granulatus scorpionism which, however, has significant sympathetic nervous system stimulation, the distinguishing features being visual disturbances, anxiety, restlessness and raised blood pressure. Scorpion antivenom should be given for both. General recommendations on management of scorpion stings are given.

Adult↗
PubMed1998

[Sensorimotor polyneuropathy and systemic amyloidosis as paraneoplastic symptoms of a carcinoid-like well differentiated carcinoma of the breast].

HISTORY AND ADMISSION FINDINGS: A 75-year-old woman was admitted because of weakness and paraesthesias in both legs. 15 years earlier a chest radiogram had shown numerous round foci of uncertain cause. Physical examination confirmed muscular weakness in all limbs, especially the legs, as well as abnormal superficial and deep sensory perception. INVESTIGATIONS: Electromyography registered a patchy pattern of intentional muscular activity and marked denervation activity but largely normal nerve conduction. There was no evidence of inflammatory disease in the laboratory tests, including the CNS. DIAGNOSIS, COURSE AND TREATMENT: The neurological findings indicated progressive axonal sensorimotor polyneuropathy. A paraneoplastic cause was suspected, but search for a primary tumour was unsuccessful. The patient developed a urinary infection from which she died in septic shock. A carcinoid-like well-differentiated carcinoma of the breast with hematogenous metastases to liver, spleen and lung was discovered at autopsy. It also revealed severe systemic AA-type amyloidosis, involving liver, spleen heart and kidneys. In addition there was a severe progressive axonal neuropathy and marked neurogenic atrophy of the peripheral skeletal musculature. No amyloid deposition was seen. CONCLUSION: In case of amyloidosis and polyneuropathy of uncertain cause a paraneoplastic pathogenesis should be considered in the differential diagnosis, even in the absence of proven malignancy.

Aged↗
PubMed2005

[Pain, osteopenia and body composition of 22 patients with Duchenne muscular dystrophy: a descriptive study].

OBJECTIVES: To study the link between pain, osteopenia and body composition in patients with Duchenne muscular dystrophy and to present a detailed questionnaire to evaluate their pain. MATERIALS AND METHODS: Twenty-two boys with Duchenne muscular dystrophy, mean age 11.4+/-4.0 years, were examined between February and March 2003. They were asked to complete a detailed questionnaire and undergo a global assessment of pain on a visual analog scale and muscular testing. They were also asked about a history of fractures. Their bone mineral content at the lumbar spine and femoral neck levels, as well as their body composition in fat and lean mass, were assessed by dual energy absorptiometry. RESULTS: The mean age for walking incapacity was 8.8+/-1.7 years. The youngest patients, who were still able to walk, had a higher level of pain than patients who depended on wheelchairs. No significant correlation was established between pain and osteopenia. One in 2 patients had spontaneous pain, and mobilization was painful for 21. The score obtained by detailed questioning about pain correlates with the average pain scores on visual analog scales. The bone mineral content was lower, especially in the lower limbs, had decreased before the inability to walk and was correlated with muscular weakness. Fractures were more frequent in mobile patients and usually occurred after a fall. CONCLUSION: Although pain in Duchenne muscular dystrophy has not been extensively studied, it is frequent and significant. Twenty-one patients had moderate to severe pain. The youngest patients had intense pain, especially during mobilisation. To evaluate this pain, we propose to use the mean results of 2 visual analog scales associated with a detailed questionnaire. However, in this study, Duchenne muscular dystrophy, pain and osteopenia were not correlated. Dual X-ray absorptiometry provides interesting information about bone mineral content, fat body mass and lean body mass. The fat body mass was higher than normal in our patients. The bone mineral content and lean body mass were lower than that for normal children, because the dystrophic process advances with age. The fracture prevalence was high, especially in young patients. Falling was the most common mechanism of fracture.

Bone Density↗
PubMed2001

A child with muscle-eye-brain disease. Ophthalmological and neurological characteristics.

PURPOSE: To describe a child with Muscle-Eye-Brain disease (MEB), one of three types of congenital muscular dystrophy associated with ocular abnormalities. METHODS: Case report. RESULTS: The child showed severe visual impairment due to progressive myopia and retinal degeneration, a pachygyria-type of migration disorder of the brain with a nodular cortical surface, i.e. cobblestone cortex, as well as muscular weakness and severe mental retardation. CONCLUSION: Ophthalmological assessments are important to help to diagnose and follow children with congenital muscular dystrophy.

Abnormalities, Multiple↗
PubMed1975

Effects of lithium on electromyographic recordings in man. Studies in manic-depressive patients and normal volunteers.

(1) EMG investigations in 17 female manic-depressive patients under long-term treatment with lithium salts showed a reduction of the maximal motor nerve conduction velocity (NCV) and of the duration of isolated potentials (IPs) in six cases. These changes, however, were not clearly due to the influence of lithium only. Psychopathology, additional medication, and other variables may have been also responsible for these finding. (2) NCV and IPs as well as the concentration of electrolytes in serum and RBC were determined in seven healthy volunteers before, during, and after lithium administration. NCV was significantly decreased and the duration of IPs slightly increased after 1 week of lithium intake. The magnesium serum concentration increased steadily during the experimental period. (3) Thus, the possibility cannot be excluded that symptoms of fatigue and muscular weakness in lithium-treated patients might be caused at least partially by changes of the peripheral nervous-muscular function.

Adult↗
PubMed1957

Myasthenial gravis; problems in diagnosis.

The possibility of myasthenia gravis must be considered in patients persistently complaining of weakness and fatigue. There may be many difficulties and pitfalls in differentiating myasthenia gravis from other disorders in which muscular weakness is a common complaint. Observation of a group of 36 patients with myasthenia gravis, and another group of 30 cases involving the differential diagnosis of myasthenia gravis, led to a conclusion that a physician should apply criteria carefully before arriving at a diagnosis of myasthenia gravis and instituting drug therapy, since nonmyasthenics may frequently respond with subjective improvement temporarily following administration of cholinergic drugs.Myasthenia gravis may be a more common disorder than was suspected in the past.

Diagnosis, Differential↗
PubMed1978

Neurologic complications of thyroid dysfunction.

Until such time as results of more rigorous studies are available, the morbidity rates for thyroid dysfunction cited here must suffice. The 1955 to 1956 outpatient "incidence" for England and Wales was 1.1 per 1,000 for thyrotoxicosis and 1.7 per 1,000 for myxedema (18). United States in-patient "incidence" for 1971 was 0.16 per 1,000 for thyrotoxicosis and 0.13 per 1,000 for myxedema (25). The 1935 to 1967 average annual incidence of Graves' disease for females in Olmsted County, Minnesota, was 30.5 per 100,000 (10). Well over 50% of hyperthyroid patients have clinical evidence of mild or moderate muscle weakness. Usually this weakness is proximal, and electro-myography and muscle biopsy confirm the existence of myopathic process (Table 11). Severe muscular weakness of acute onset is relatively rare and is encountered in approximately 1% of hyperthyroid patients (11,17,40). Ophthalmoplegia and psychosis are reported 4% and 2% of patients, respectively (17). Myasthenia gravis, although well publicized, is estimated to occur in less than 1% of patients (3,30). TPP is virtually nonexistent in the West; in the Orient it is reported in 2 to 8% of hyperthyroid patients and is 20 to 60 times more frequent in the hyperthyroid male than in the hyperthyroid female (Table 12). The neurologic symptomatology of myxedema is more extensive, and agreement among the various series is poor. The only unselected series addressing itself to neuromuscular manifestations of myxedema that is suitable for citation is that of Scarpalezos et al. (36). This comprehensive study was done without apparent patient selection, and it reported 2% of patients with definite carpal tunnel syndrome, 6% with myopathy, and 18% with polyneuropathy (Table 13). Reported percentages of hypothyroid patients found to have neurologic manifestations of cerebellar dysfunction are extremely diverse: ataxic gait was reported in 5 to 32% (6,7,12,27) of patients and dysdiadochokinesia in 6 to 52% (7,12,27). Psychosis is encountered in 2 to 5% (6,14,17,27,39) of myxedematous patients, memory loss in 23 to 55% (6,14,27), and coma in less than 1% (27).

Adult↗