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At least 577 records · Page 32Linked to original sources
PubMed2005

[Neurotomy of the tibial nerve for treatment of the talipes equinovarus].

OBJECTIVE: To explore indication and approaches of neurotomy of tibial nerve for the treatment of the talipes equinovarus and spastic paralysis. METHOD: A total of 25 patients including 15 patients with cerebral paralysis and other 10 patients were diagnosed with clear etiology, spastic muscles with supplied nerves were analyzed in detail, neurotomy of the tibial nerve was performed under microscope, during operation, motor nerve was lovated with electronic stimuli and monitored with induced electromyography. The surgical results were analyzed. RESULTS: A total of 36 of 37 (97%) neurotomy of the tibial nerve were improved with dorsum flex of ankle at 10 - 45 degree, and 22 of 24 (85%) talipes equinovarus improved clinically. Of 37 feet with surgery, 24 feet (65%) were in normal position and could touch ground completely, 9 feet (24%) had 10 degree with ground or could contact ground with external one third of the feet, 4 feet (11%) were abnormal. Of 25 patents, 21 (84%) had improvement of motor activity at discretion, 5 patients (20%) improved dramatically. All the 4 patients failed after the operation were cerebral paralysis, and were presumably related to disorders of spinal function, abnormal reflex and the disappearance of inhibitory reflex. CONCLUSION: Neurotomy is an effective method to treat talipes equinovarus, and can improve the motor activity of low extremity.

Adolescent↗
PubMedDate not supplied

Using a coma scale to assess patient consciousness levels.

The Glasgow coma scale is the most widely used method for assessing a patient's level of consciousness. This article outlines the Leeds Teaching Hospitals NHS Trust's guidelines to assist practitioners with the practical aspects of carrying out and interpreting the scale.

Consciousness Disorders↗
PubMed2005

Bilateral vestibular loss after caloric irrigation: clinical application of vestibular rehabilitation.

UNLABELLED: Bilateral vestibular loss is a rare diagnosis among patients with dizziness and imbalance. Nevertheless, symptoms are often disabling and therapy has yet to be established. AIM: To evaluate and describe the clinical outcome of patients with imbalance due to bilateral vestibular loss after a caloric test treated with vestibular rehabilitation. STUDY DESIGN: Retrospective case report. METHOD: Pre- and post-treatment outcomes were evaluated in 8 individuals suffering from post-caloric bilateral vestibular paresis who were submitted to vestibular rehabilitation. RESULTS: Clinical improvement after vestibular rehabilitation was observed in 7 (87.5%) of the 8 patients. CONCLUSION: Although complete compensation for bilateral vestibular loss is not expected, vestibular rehabilitation may be used as a therapeutic method in these patients.

Adult↗
PubMedDate not supplied

[Miller Fisher syndrome: review of the literature and presentation of 2 cases].

Miller Fisher Syndrome (MFS), which is characterized by ophthalmoplegia, ataxia and tendon areflexia, is generally considered as a clinical variant of Guillain-Barré Syndrome. However some features of the disease are still debated, particularly regarding possible central nervous system involvement. After presenting two new cases of MFS, the authors provide a critical review of the literature and discuss the nosographical position of the disease. The main conclusions can be summarized as follows: MFS is a predominantly axonal inflammatory neuropathy with prevailing involvement of oculomotor nerves. It is associated to spinal multi or polyneuropathy, which in mildly affected cases is manifested by areflexia, while in severe ones it can be responsible of sense and/or motor impairment. In addition to peripheral neuropathy CNS involvement, exclusive or more marked in posterior fossa, occurs not infrequently. The prognosis of the disease is often benign, but disabling or even fatal outcome is possible. Corticosteroid treatment, possibly because of antiinflammatory and/or immunosuppressive action, could be effective in some patients. Finally, in spite of some similarities with GBS, MFS should be considered as a separate entity with its own nosographical position.

Adult↗
PubMed2006

Neonatal hyperekplexia: the Stiff-Baby syndrome.

Neonatal hyperekplexia is a rare autosomal dominant startle disorder. Presenting soon after birth, it is often mistakenly diagnosed as spastic quadriparesis, epilepsy etc. While the long-term prognosis is relatively benign, sudden death due to severe spasms have been seen in sporadic cases. We report a case of hyperekplexia with some typical and some unusual findings.

Female↗
PubMedDate not supplied

[Achillean reflexogram : its measurement and its correlations with various clinical and biological factors in 2 working male populations].

The achillean reflexogram has been recorded according to Gilson's photo-electric technique among two male populations during routine cardio-vascular screening. The first population concerns 706 men aged 21 to 55 and the second one 4 437 subjects aged 46 to 52. The frequency of bilateral areflexy increases with age (from 3% before 30 to 6% after 40); it is significantly associated with the presence of angina pectoris. However, no relation is observed with diabetes or clinical suspicion of myocardial infarction. Whereas fat body mass is positively associated with the reflex duration the latter is reduced with heart rate, systolic blooc pressure and number of blood erythrocytes and leucocytes increased. These results and the interest of systematic reflexogram recording during health check up are discussed.

Achilles Tendon↗
PubMed1991

Iatrogenic saphenous neuralgia: successful therapy with neuroma resection.

We report the case of a patient with saphenous neuralgia secondary to iatrogenic trauma resulting from bypass surgery in the femoral-popliteal region. Early symptoms of this condition were medial calf and ankle pain, with no findings of motor and reflex abnormalities. Exploration of the thigh 2 years later revealed a neuroma of the nerve in the distal dissection site, medial to the knee. Resection of the neuroma alleviated this condition. It is noted that saphenous neuropathy is seen as a spontaneous entrapment syndrome as well as a complication of orthopedic and vascular procedures performed on the medial area of the knee. Saphenous neuralgia is often not recognized by neurosurgeons. If the condition is intractable, it does respond to surgical therapy.

Femoral Artery↗
PubMed1991

[Mechanisms and consequences of changes of the vasomotor activity in cardiac insufficiency].

Changes in vasomotor tone in cardiac failure are related to the severity of the cardiac failure. The causative factors include dysfunction of the baroreceptor reflex, abnormal stimulation of the normal physiological regulators of cardio-circulatory function such as the sympathetic nervous and the renin-angiotensin-aldosterone system, and certain local factors characteristic of cardiac failure such as salt and water retention at vascular wall and interstitial level or changes in the metabolism of certain tissues. These changes are variable according to the region perfused and their interaction results in preferential redistribution of blood flow to the coronary and cerebral circulations at the expense of other regions such as the splanchnic and cutaneous vessels. In addition, they play a key role in the adaptive peripheral mechanisms to left ventricular failure and to the modulation of the vascular effects of drug therapy. An improvement in our understanding of these mechanisms and their consequences is important from the physiopathological, prognostic and therapeutic points of view.

Cardiac Output↗
PubMedDate not supplied

[The inverted ipsilateral reflex: is it an artefact?].

We have studied the characteristics of the inverted reflex obtained by ipsilateral stimulation in nineteen patients. Six of them were affected by perceptual hypoacusis, eleven of those patients had an otosclerosis and two a facial paralysis. The conclusion about our investigation is that in all the cases, it was produced by an artefact and it was not a response from the muscles of the middle ear.

Facial Paralysis↗
PubMed1990

Tone and reflex development before term.

The evolution of tone and reflexes from 25 weeks postmenstrual age (gestational age plus chronologic age) to term in a population of 42 surviving infants is described. The infants were born in 1983 at the Johns Hopkins Hospital, had birth weights less than 1300 g, were examined weekly until neonatal intensive care unit discharge, and did not develop cerebral palsy. Lower-extremity flexor tone was first detectable at 29 weeks post-menstrual age by the popliteal angle and heel to ear maneuvers. Flexor tone, recoil, and hyperreflexia were all noted 2 to 3 weeks earlier in the lower extremities (33 to 35 weeks) than in the upper extremities (35 to 37 weeks). Hip tone (35 to 37 weeks) followed knee flexor tone, but preceded shoulder tone (37 to 38 weeks). Trunk tone on ventral suspension emerged closer to term (36 to 40 weeks), and more than half of infants evaluated at term continued to demonstrate head lag when pulled to sitting position. The emergence of the primitive and pathologic reflexes reflects (both in timing and pattern) the evolution of tone: development of the reflexes in the lower extremities precedes that of those in the upper extremities, and development of the distal reflexes precedes that of the proximal. Maturation of tone, deep tendon reflexes, pathologic reflexes, and primitive reflexes occurs in an orderly, sequential manner, with a well-defined pattern: caudocephalad (lower extremities to upper extremities) and centripetal (distal to proximal).

Child Development↗
PubMed1990

The patellar reflex in preeclamptic women with subtherapeutic and therapeutic serum magnesium levels.

The normalization of hyperreflexia has been proposed by some authorities as an indicator of adequate seizure prophylaxis in preeclamptic women receiving magnesium sulfate. To test this hypothesis the patellar reflex response was measured with a quantitative technique in 20 preeclamptic patients during their progression from subtherapeutic to therapeutic serum levels of magnesium. Patients meeting selected criteria for hyperreflexia demonstrated a 46% decrease in their reflex response. Those without initial hyperreflexia failed to demonstrate a significant decrease.

Adolescent↗