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Results for “HEMIPLEGIA”

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At least 559 records · Page 31Linked to original sources
PubMed1995

Effects of transcutaneous electrical nerve stimulation (TENS) on spasticity in patients with hemiplegia.

The effect of afferent cutaneous electrical stimulation on the spasticity of leg muscles was studied in 20 patients with chronic hemiplegia after stroke. Stimulation electrodes were placed over the sural nerve of the affected limb. The standard method of cutaneous stimulation, TENS with impulse frequency of 100 Hz, was applied. The tonus of the leg muscles was measured by means of an electrohydraulic measuring brace. The EMG stretch reflex activity of the tibialis anterior and triceps surae muscles was detected by surface electrodes and recorded simultaneously with the measured biomechanical parameters. In 18 out of 20 patients, a mild but statistically significant decrease in resistive torques at all frequencies of passive ankle movements was recorded following 20 min of TENS application. The decrease in resistive torque was often (but not always) accompanied by a decrease in reflex EMG activity. This effect of TENS persisted up to 45 min after the end of TENS. The results of the study support the hypothesis that TENS applied to the sural nerve may induce short-term post-stimulation inhibitory effects on the abnormally enhanced stretch reflex activity in spasticity of cerebral origin.

Adult↗
PubMed1977

Systemic lupus erythematosus complicated by panniculitis, optic atrophy, and hemiplegia: report of a case.

A case is presented of a patient with systemic lupus erythematosus who had three of its rarest complications--panniculitis, optic atrophy, and hemiplegia, the latter two occurring despite adequate corticosteroid therapy. There appears to be a missing link in this patient's immune mechanism, which faulted her complete response to corticosteroid therapy and led to the three complications.

Adipose Tissue↗
PubMedDate not supplied

[Alternating hemiplegia as a migraine equivalent in a small child].

The authors present the diagnostic criteria, clinical course and additional examinations in alternating hemiplegia (ah). According to International Headache Classification ah belongs to the syndromes which precede or accompany migraine. We give a description of the case which is the first published in Polish literature and discuss the etiology supporting the connection of ah with migraine.

Age of Onset↗
PubMed1995

[Clinical observation on treatment of 40 cases of apoplexy hemiplegia complicated shoulder-hand syndrome with electro-acupuncture].

The authors treated 40 cases of shoulder-hand syndrome of apoplexy hemiplegia with electro-acupuncture (EA) and filiform needle acupuncture (FNA) respectively. The results showed that EA had better results in treating hand back swelling, hand skin temperature elevating and the bending finger caused pain than that with FNA (P < 0.05). The finger joint and shoulder joint improvement (the functional scoring increased for 3 points or more) in EA was also better than that of FNA (P < 0.05). The total marked effective rate was higher in EA group (75%) than that in FNA (50%), P < 0.05). It suggested that EA produced rhythmic muscle contraction which had a "shoulder-hand pump" like action, and is significant in eliminating hand back swelling and preventing atrophy of hand muscles.

Acupuncture Therapy↗
PubMed1996

[Akinetic mutism with right hemiplegia caused by infarction in the territory of the left anterior cerebral artery].

A 65 years old woman with chronic high blood pressure and diabetes mellitus presented with a mutism akinetic of sudden onset and a right total hemiplegia with a Babinski sign secondary to a left anterior cerebral artery infarction. She had had six months earlier a transient gait disturbance. At that time, the CT scan showed lacunar infarcts of the head of both caudate nuclei. Neuropathological examination revealed that the left infarction of the anterior cerebral artery involved the superior frontal gyrus, the supplementary motor area, the cingulate gyrus and the corpus callosum. There were also multiple lacunes of the head of both caudate nuclei, anterior limb of the internal capsules, white matter, basal ganglia and thalami. The mutism akinetic was thought to be the result of a bilateral disruption of a functional loop including on each side, the supplementary motor area, the cingulate gyrus, the subcallosal tract and the head of the caudate nucleus. On the right side, the lesion of the caudate nucleus could have interrupted this loop normally involved in the induction of voluntary movements and in the communication with the external surroundings.

Aged↗
PubMed1996

Efficacy of prosthetic laryngoplasty with and without bilateral ventriculocordectomy as treatments for laryngeal hemiplegia in horses.

OBJECTIVE: To evaluate the efficacy of prosthetic laryngoplasty with and without bilateral ventriculocordectomy for treatment of experimentally induced left laryngeal hemiplegia (LLH). ANIMALS: 15 adult Standardbreds. PROCEDURE: Horses were allotted to 3 equal groups. Sham operation (group 1), prosthetic laryngoplasty (group 2), or prosthetic laryngoplasty with bilateral ventriculocordectomy (group 3) was performed after induction of LLH. Upper airway function testing was performed prior to left recurrent laryngeal neurectomy (LRLN), 14 days after LRLN, and 60 and 180 days after surgical treatment. Measurements were obtained at rest and at treadmill speeds corresponding to 75 and 100% of maximal heart rate. Videoendoscopy was performed at rest and during exercise in all horses prior to LRLN and 60 and 180 days after surgical treatment. Upper airway endoscopy was performed immediately after LRLN to document induction of grade-IV LLH. Also, horses in group 3 were endoscopically examined at 7, 14, 21, 28, and 120 days after surgical treatment to evaluate healing of the ventriculocordectomy sites. RESULTS: When horses were at rest, significant differences were not apparent between groups at any period or between periods for any measured variable. LRLN induced airway obstruction in all horses during exercise. In sham-operated horses, this obstruction was unaffected by time. In contrast, 60 and 180 days after surgical treatment, inspiratory flow limitations induced by LRLN were reversed in horses of groups 2 and 3. There were no significant differences between the 2 treatment groups. Endoscopy revealed the left arytenoid cartilage abducted beyond the intermediate position, but not touching the pharyngeal wall in all horses with a laryngeal prosthesis. After surgical treatment, 4 group-2 horses had filling of both ventricles with air during exercise. There was moderate to marked swelling of the ventriculocordectomy sites immediately after surgery, and this swelling resolved by 7 days after surgery. The ventriculocordectomy sites looked best at 14 and 180 days. CONCLUSIONS: 60 and 180 days after prosthetic laryngoplasty, upper airway function returned to pre-LRLN values in horses with experimentally induced LLH exercising at 100% of maximal heart rate. Combining ventriculocordectomy with prosthetic laryngoplasty does not further improve upper airway function in these horses.

Animals↗
PubMed1997

Recovery of erosive rheumatoid arthritis after human immunodeficiency virus-1 infection and hemiplegia.

The effects of human immunodeficiency virus type-1 (HIV-1) infection on rheumatoid arthritis (RA) are a matter of debate as there is no agreement on the influence of HIV-1 related immunodeficiency on this disease. We describe a patient with RA with symmetric joint erosions and positive rheumatoid factor (RF) who developed classic acquired immunodeficiency syndrome (AIDS) followed by left hemiplegia. RA improved with resolution of bony erosions and disappearance of RF, and reached complete clinical remission only in the paralytic limbs. Our observation suggests that, although essential, cell mediated immune response is not the sole mechanism involved in RA pathogenesis. Other factors such as the nervous system may play an important role.

Arthritis, Rheumatoid↗
PubMed1996

[Pure motor hemiplegia with ipsilateral lingual palsy caused by pontine infarction].

A 36 year old diabetic man developed a pure motor hemiplegia (PMH) associated with an ipsilateral lingual palsy. Magnetic resonance imaging revealed a pontine infarct. Lingual palsies have never been reported in patients with PMH so far, but may be associated with other lacunar syndromes such as the "dysarthria-clumsy hand syndrome". This observation supports the hypothesis that corticohypoglossal pathways may have bilateral and assymetrical projections.

Adult↗
PubMedDate not supplied

Noninvasive assessment of posterior cerebral artery stenosis inducing hemiplegia.

Posterior cerebral artery infarction usually causes hemianopsia and, occasionally, symptoms referred to infarction in the territory of the middle cerebral artery. We describe a case of cerebral infarction of the posterior cerebral artery territory that mimicked middle cerebral artery occlusion. A patient with infarction of the right surface and deep territories of the posterior cerebral artery presented with left hemiplegia and left homonymous hemianopsia. Brain computed tomography and magnetic resonance investigation disclosed a hypodense lesion in the occipital right lobe and the medial and inferior part of the right temporal lobe. Transcranial Doppler studies disclosed an abnormally increased blood flow velocity in the proximal posterior cerebral artery and a sharp reduction in distal flow velocity. This case underscores the utility of noninvasive techniques to diagnose posterior artery stenosis: they were not only more economical than angiography but also spared the patient discomfort and risk.

Aged↗
PubMed1998

Reflex sympathetic dystrophy syndrome in stroke patients with hemiplegia-three phase bone scintigraphy and clinical characteristics.

In an attempt to investigate the correlation between three phase bone scintigraphy (TPBS) and the clinical manifestation of reflex sympathetic dystrophy syndrome (RSDS) in the upper extremity of hemiplegia, we collected 30 patients with cerebral vascular accidents (CVA) confirmed by head computed tomography (infarction or hemorrhage) within 3 months of their CVA event. All patients received TPBS after admission. Clinical assessment for the development of the RSDS was done at least 3 months (268 +/- 120 days) after the stroke. The correlation between the development of RSD and certain clinical variables (including sex, age, side affected, caused of stroke, and motor stage) were analyzed. Twelve patients (40%) manifested definite or probable RSDS, as assessed by Tepperman's criteria, during the follow-up period. Nineteen patients (63%) exhibited radionuclide evidence of RSDS based on delayed bone scan criteria performed within 3 months (43 +/- 25 days) of the stroke. The positive delayed image of TPBS demonstrated a sensitivity = 92%; specificity = 56%; positive predictive value = 58%, and negative predictive value = 91%. The Kappa statistics for agreement between positive bone scan and RSDS development was 70% (Kappa = 0.43, p < 0.05). Neither sex, age, side affected, cause of stroke, or motor stage had a significant correlation with clinical RSDS. In conclusion, TPBS is a useful screening tool for the development of RSD in hemiplegic patients. However, the diagnosis of RSDS depends on the clinical evaluation and that TPBS as an adjunct assessment of RSDS must be interpreted with caution.

Adult↗
PubMed1998

Spastic hemiplegia of the upper extremity in children.

Care of upper extremity problems in hemiplegic children requires careful evaluation and planning. This article focuses on the evaluation and treatment of spastic hemiplegia attributable to cerebral palsy. All treatments must take into consideration the level of static and dynamic motor deformity; levels of discriminatory sensibility, intelligence, and motivation; and overall level of function. The treatments discussed are designed to improve the child's musculoskeletal condition but do not cure the underlying disease.

Arm↗
PubMed1998

Measurement of impaired muscle function of the gastrocnemius, soleus, and tibialis anterior muscles in spastic hemiplegia: a preliminary study.

Based on the results of several electrodiagnostic and biomechanical studies, the following classification of muscle dysfunction in spastic hemiplegia is proposed: changes in muscle activation (excess symptoms, e.g., spasticity, and deficit symptoms, e.g., paresis); changes in muscle stiffness; and changes in muscle length. The clinical significance of this classification is that different types of muscle dysfunction might require specific treatment. The authors have developed techniques to measure quantitatively each type of muscle dysfunction: free frequency repetitive movement (FFRM) and torque angle diagram (TAD). Surface EMGs of tibialis anterior, gastrocnemius, and soleus muscle are recorded during active (FFRM) and passive (TAD) ankle movements. EMG data are converted to parameters for abnormal muscle activation (excess and deficit symptoms). Parameters for muscle stiffness and muscle length are derived from the hysteresis curve of the TAD. This article describes the measurements and the results of a validation study. For the validation study, four hypotheses were formulated: 1) in nonimpaired control subjects, parameters expressing abnormal muscle activation are low; 2) in hemiplegic subjects, differences between the affected and the unaffected sides will be found for all types of parameters; 3) after local anaesthesia of the tibial nerve on the hemiplegic side, excess symptoms will decrease, while muscle stiffness remains unchanged; and 4) despite a uniform gait pattern, between-subject differences can be detected with regard to muscle activation, stiffness, and length. The first hypothesis was tested and confirmed in two controls; the remaining three were tested and confirmed in ten hemiplegic subjects (mean age 47.7 yrs, mean time since onset 10.7 yrs). However, the level of co-contraction of the gastrocnemius muscle was low, probably indicating that the clinical significance of this phenomenon might be limited. The results support the validity of the proposed classification and measurements.

Adult↗
PubMedDate not supplied

Initial motor unit recruitment in patients with spastic hemiplegia.

Lesions of the first motor neuron provoke abnormal voluntary movements. To clarify the central nervous system mechanisms underlying these changes we analyzed the behavior of the first motor unit recruited during a minimal effort tonic contraction of the deltoid and abductor digiti minimi manus muscles in patients with hemiplegia due to cerebrovascular lesions in the distribution of the middle cerebral artery. We compared data from paretic and healthy muscles in the same subject. The onset and recruitment intervals determined for the single motor unit yielded the range of control. The first recruited motor unit had a lower baseline firing rate and the second recruited motor unit potential appeared significantly earlier (p < 0.01) in plegic than in healthy muscles. Both changes affected distal more than proximal locations. Recordings from plegic muscles, particularly at distal locations, also disclosed a lowered range of control. These findings suggest that in hemiplegic patients the central nervous system loses its ability to modulate the frequency of firing during minimal effort voluntary movements so that distal muscles tend to behave like proximal muscles.

Aged↗
PubMed2002

Increased FDG uptake in the ipsilesional sensorimotor cortex in congenital hemiplegia.

The resting brain metabolism was estimated in six children suffering from a right congenital hemiplegia (CH) of subcortical origin. This estimate was based on the 18F-labeled 2-deoxy-2-fluoro-d-glucose (FDG) uptake measured by means of positron emission tomography and compared, using statistical parametric mapping (SPM99), with that of six control subjects. The contrast [CH children - Controls] showed that CH children had two loci of relatively higher FDG uptake. The larger voxel cluster was found in the ipsilesional hemisphere and comprised the primary motor and somatosensory cortices and left inferior parietal lobule. The other cluster was located in the contralesional hemisphere and encompassed the primary motor cortex, callosomarginal sulcus, and cingulate gyrus. The reverse contrast [Controls - CH children] showed that control subjects had a relatively higher FDG uptake bilaterally in the temporal and hippocampal gyri, the rostral part of the brain stem, the thalami, the putamen, and the superior frontal gyri. A crossed cerebellar diaschisis was not observed in CH children. This relatively higher FDG uptake in the ipsi- and contralesional motor areas of CH children stands out in contrast to the hypometabolism (diaschisis) frequently observed in adult stroke patients with a subcortical lesion. This increased FDG uptake in the disconnected ipsilesional motor areas may reflect a long-term adaptation leading, for example, to an increased synaptic density and/or activity or to a change in the density of glucose transporters.

Adolescent↗
PubMedDate not supplied

Equine laryngeal hemiplegia. Part III. Treatment by laryngoplasty.

During the years 1971-1979, 127 horses with left laryngeal hemiplegia were studied. The physical characteristics and clinical signs observed in this study were recorded in Part I and Part II of ths series of papers. Of these 127 horses, 81 were treated by the laryngoplasty procedure. Complications of surgery are described and the effects of the operation on respiratory noise and performance are evaluated. In 54.8% of horses the chronic respiratory noise observed during exercise was apparently diminished or eliminated post-operatively. The performance of 44% of horses was apparently improved after surgery. Post-operative racing success occurred in 38% of horses treated. Satisfactory arytenoid adduction as assessed endoscopically within 9 days of surgery was achieved in 77% of cases. Surgical failure appeared to be related to cutting of the laryngeal cartilages by the prosthesis and techniques to minimise this are discussed.

Journal Article↗
PubMed1986

Equine laryngeal hemiplegia. Part II. An electron microscopic study of peripheral nerves.

The recurrent laryngeal nerves were examined by electron microscopy in five control, four subclinical and four clinical laryngeal hemiplegic horses. In addition, the peroneal nerve was examined in two horses in the latter group. The distally distributed loss of large myelinated fibres in the left recurrent laryngeal nerve seen by light microscopy was confirmed. In addition, active axonal pathology was found to be more evident than indicated by light microscopic investigations. The onion bulb formations observed indicated the repetitive nature of the damaging influence to nerve fibres. Although the pathological changes were most obvious in the distal left recurrent laryngeal nerve, alterations similar in type and distribution were present in other areas of the left and right nerves, and in the distal hindlimb nerves. The observation of fibres with inappropriately thick myelin sheaths relative to their axonal calibre, was confirmed statistically by determining the regressions of axis cylinder perimeter against the number of myelin lamellae. In conclusion, the peripheral nerve pathology of equine laryngeal hemiplegia was demonstrated to be a distally distributed loss of myelinated fibres, with considerable active axonal damage, in conjunction with axonal atrophy. These features suggest that this disease may be classified as a distal axonopathy.

Journal Article↗
PubMed1986

Equine laryngeal hemiplegia. Part IV. Muscle pathology.

This study confirmed that neurogenic muscle pathology exists in intrinsic laryngeal muscles supplied by the recurrent laryngeal nerves in horses subclinically and clinically affected with laryngeal hemiplegia. An important additional observation was the occurrence in three out of four laryngeal hemiplegic horses of neurogenic muscle changes in a hindlimb muscle, the extensor digitorum longus, a muscle supplied by another long peripheral nerve. This finding suggests that a polynenropathy exists in laryngeal hemiplegic horses, and supports the classification of this disease as a distal axonopathy. Comparison of the degree of pathology in the intrinsic laryngeal muscles and that of the recurrent laryngeal nerves innervating them, demonstrated a strong correlation between the extent of damage in the distal left recurrent laryngeal nerve and the overall degree of muscle pathology. The muscle damage in clinically affected horses is a reflection of the nerve damage present in the most distal portion of the recurrent laryngeal nerve. The more variable pathological changes found in proximal levels of the left and right recurrent laryngeal nerves probably reflects the ongoing nature of the pathological process affecting nerve fibres. The existence of a subclinically affected group of horses, the earliest involvement of an adductor, the left cricoarytenoideus lateralis muscle, and the presence of changes in the right intrinsic laryngeal muscles all confirmed the findings of previous workers.

Journal Article↗