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Peripheral nerve injury was associated with fracture or fracture-dislocation of the pelvis in 23 dogs and 11 cats. In most cases, peripheral nerve injury resulted from ilial fracture with craniomedial displacement of bone fragments, or from sacroiliac fracture-dislocation with cranial displacement of the ilium. Sciatic nerve injury was associated with fracture of the acetabulum in 2 dogs. A combination of sensory, voluntary motor, and reflex abnormalities were observed in the ipsilateral extremity of affected animals. Signs of severe pain were noticed in 4 of the dogs and in 1 cat. Eight of the animals died or were euthanatized for reasons not directly related to the severity of peripheral nerve injury. Of the remaining 26 animals, 21 (81%) had good or excellent limb function 16 weeks after peripheral nerve injury was sustained. Limb function was lost or self-mutilation occurred in 4 (15%) of the animals.
Recent investigations comparing the postural responses of normals and patients with bilateral peripheral vestibular deficit to a sudden backwards tilt of the support surface about the ankle joints have permitted an objective definition of the timing and amplitude of vestibulo-spinal reflex (VSR) EMG responses in ankle and neck muscles. The muscle contractions result in a sway stabilizing action correcting for induced body tilt, whose effect may be observed in ankle torque, and body and head angular acceleration records. The same techniques were used to monitor VSR responses of 10 patients with suspected simulated, aggravated, or psychogenic vertigo--vertigo of functional origin. Two cases, presented in detail, illustrate the identification of weak reflex responses for patients aggravating an organic VSR pathology during the Romberg test and the identification voluntarily controlled destabilizing responses for patients with a simulated or psychogenic vertigo. Recording the vertical vestibulo-ocular reflex in the same rotation plane as induced tilt is shown to provide valuable additional information on a possible peripheral vestibular pathology. It is concluded that VSR responses time-locked to a vestibular stimulus provide an improved means of identifying a functionally based vertigo.
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This is the first description of the "startle reaction" observed in young children and of the technique of its stimulation. On the basis of the study of 38 children with the given symptom and of 30 control children aged up to 6 months the independence and pathologic nature of the startle reaction have been proved. 12-month follow-up of both groups has allowed the authors to draw up the conclusion about the prognostic significance of the symptom for the development of epileptic phenomena in children. A principle of preventive therapy for the prophylaxis of convulsive manifestations and reducing the duration of the anticonvulsive therapy is proposed.
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After meperidine administration during labor, meperidine reaches its highest level in fetal tissues within 2-3 hr. The highest levels of normeperidine, the active metabolite of meperidine, are, on the other hand, determined in fetal tissues by the time between administration of meperidine to the mother and delivery: the greater the drug-to-delivery interval (DDI), the higher the fetal levels of normeperidine. Because of the different times to peak fetal levels of meperidine and normeperidine, it may be possible to partially separate the effects of meperidine and its metabolite on the neonate using the DDI. The purpose of this study was to determine whether low doses of meperidine affected performance on the Brazelton Neonatal Behavioral Assessment Scale (BNBAS), and whether this performance is related to the DDI or to levels of meperidine or to normeperidine. Sixteen control neonates whose mothers received no meperidine and 41 study infants whose mothers received 25-100 mg meperidine intravenously (mean 39 +/- 19 mg) were studied. Comparisons of BNBAS scores of control and study infants measured at less than 12 hr, again at 3 days of age, and the effect of DDI were made using repeated measures analyses of variance (ANOVA). Correlation techniques were used to examine relationships between BNBAS performance and clinical and pharmacological variables related to drug administration. The BNBAS cluster scores representing regulation of state and number of abnormal reflexes were significantly different in study neonates from control neonates. Performance depended upon test day. Further analysis showed that longer DDIs resulted in less optimal BNBAS performance.(ABSTRACT TRUNCATED AT 250 WORDS)
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The study of H-reflexes, their latent periods and M-responses involved 69 patients with trauma to the spinal cord. The results showed that these parameters were normal in 39 patients. The remaining patients lacked H- or M-responses, which was indicative of inhibition of neural and muscular activity due to disorders of hemodynamic and metabolic processes in the spinal cord or in muscles of the lower extremities. The study of latent periods and the speed of impulse conduction along the peripheral nerve revealed that after an injury to the spinal cord some patients presented impairment of impulse conduction at the level of the spinal cord or spinal radicles as a result of their compression.
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