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At least 1,099 records · Page 61Linked to original sources
PubMed1995

[Prolonged muscle paralysis after long-term infusion of muscle relaxants and large doses of steroids].

We have recently encountered three patients who developed prolonged muscle paralysis after long-term infusion of muscle relaxants and administration of large doses of steroids. Among many factors implicated in the cause of this paralysis, steroids and muscle relaxants were suggested to be most likely causative agents. In order to avoid such muscle paralysis, we must be careful to limit the dose of relaxants as small as possible. For this purpose, monitoring of neuromuscular blockade is indispensable.

Female↗
PubMed1994

Cephalic zoster with laryngeal paralysis.

Herpes zoster reactivaction in the head and neck region is often associated with multiple cranial neuropathies, the most common one being facial paralysis. Laryngeal paralysis has also been occasionally reported with zoster infection. We present two such cases, and discuss the relevant literature on the pathophysiology, evaluation and management of this disease. Recent advances in antiviral therapy have allowed for specific medical treatment, thus making it all the more imperative to suspect zoster, even in clinically atypical cases. We suggest aggressive treatment with intravenous acyclovir for cephalic zoster complicated by vocal cord paralysis.

Acyclovir↗
PubMed1993

[Salivation in the submandibular salivary gland in the prognosis of peripheral facial nerve paralysis. Clinical study].

The relationship between the quantitative submandibular gland secretion and neural motor function was examined in 157 patients with different types of peripheral facial paralysis. These two functions were followed up during the period of one year. In the patients with 40%, or more, of submandibular gland secretion one month after the onset of facial paralysis, the motor nerve function recovery was satisfactory, while, in the patients with submandibular gland secretion less than 20% the recovery was unsatisfying. When the submandibular gland secretion was more than 50% in the early stage of facial paralysis, the complete recovery was within 6 months. On the contrary, when it was less than 50%, the recovery period was much longer.

Facial Paralysis↗
PubMed1994

Sudden onset of paralysis in a twenty year-old male patient.

We report on a twenty year-old male patient who presented with sudden onset of flaccid paralysis. After exclusion of central nervous system involvement, marked hypokalemia pointed to the diagnosis of hypokalemic periodic paralysis, which was completely reversible on oral and parenteral potassium substitution. A provocation test with glucose and insulin administration leading to hypokalemia and incipient paralysis of the limbs confirmed the diagnosis. Pathogenetically, this syndrome is characterized by an excessive shift of potassium ions into the muscle cells. Therapeutic measures include potassium-sparing diuretics, beta blockers, acetazolamide or diclofenamide. In less severe cases, oral potassium may be sufficient to reverse the symptoms.

Administration, Oral↗
PubMed1994

[Osteochondrosis syndrome and arthropathia deformans as the cause of habitual and stationary luxatio incompleta of the sixth thoracic vertebra in laying hens with paralysis].

151 laying hens were kept in two experiments until the age of 610 or 786 days in floor pens, large cages with flat wire floor or small cages having inclined wire floor bottoms of 8 or 15 degrees. Paralysis was observed in 24 of the 151 hens. There was no relationship between the incidence of paralysis and the different housing systems. Fractures of the vertebral column or decreased stability of the skeleton were not observed. But in all of the 24 hens the paralysis was the result of the compressed spinal cord. The cause of the compression was the luxatio incompleta of the 6th thoracic vertebra. Different degrees of arthropathia deformans were observed in the diarthrotic vertebral joints of all the hens of the two experiments. The arthrotic lesions were accompanied by deformed articular surfaces. The destroyed and deformed articular surfaces were the cause of the instability of the 6th thoracic vertebra with spondylolisthesis or luxatio incompleta. The hypothesis, that the arthrotic lesions developed during the growing period of the hens, was supported by histological findings of disturbed growth of the epiphyseal cartilage. Overstressing of the epiphyseal cartilage was the causative agent of the arthrotic lesions in the vertebral joints. In this way the lesions are very similar to the osteochondrosis syndrome in broiler chickens and fast growing mammals.

Animals↗
PubMed1993

[Periodic hypokalemic paralysis in thyrotoxicosis].

The case is reported of a 26-year-old Chinese cook hospitalized for hypokalemic paralysis, the cause of which was found to be thyrotoxicosis. In Asian males hypokalemic periodic paralysis occurs in 2% to 10% of thyrotoxic patients with a male:female ratio of close to 70:1. In the white population the frequency is smaller by a factor of 10. This association is however considered important, since the clinical symptoms of thyrotoxicosis may be scanty. By successful treatment of thyrotoxicosis hypokalemic paralysis disappears, but may return after cessation of treatment. Pathogenetically, hyperreactivity of the sodium/potassium pump of the cell membrane seems to play an important role.

Adult↗
PubMed1993

[A case of right phrenic nerve paralysis as a complication of internal jugular vein cannulation by anterior approach].

We report a case of right phrenic nerve paralysis caused accidentally by compression after internal carotid artery puncture. Postoperatively she received respiratory management and conservative treatment after extubation. Cases of phrenic nerve paralysis following cardiac surgery have been reported, but paralysis as a complication of internal jugular vein cannulation by anterior approach is rare.

Accidents↗
PubMed1993

[Sciatic nerve paralysis following intraarterial chemotherapy for bladder cancer: reports of two cases].

Bilateral sciatic nerve paralysis developed in two patients with invasive bladder cancer following intraarterial infusion of cisplatin (CDDP) and 4'-0-tetrahydropyranyladriamycin (THP) as preoperative adjuvant chemotherapy. Balloon catheters were selectively inserted into both internal iliac arteries, and CDDP 100 mg/m2 and THP 40 mg/m2 were administered under balloon occlusion. Pain of lower extremities developed soon after infusion and was gradually followed by paralysis. One patient recovered from paralysis partially after 4 months, but the other patient didn't recover. The use of balloon catheters resulted in an excessive concentration of chemotherapeutic agents with the adverse action on the sciatic nerves.

Aged↗
PubMed1993

Genetic study of hyperkalemic periodic paralysis in horses.

Four Quarter Horses (1 stallion, 3 mares) with hyperkalemic periodic paralysis were mated to unaffected horses to determine the genetic basis of the disease. The affected stallion was bred to 11 unaffected mares (4 Quarter Horses, 1 Arabian, 2 Standardbreds, and 4 Thoroughbreds). The 3 affected mares were bred to an unaffected Quarter Horse stallion. Of the 15 offspring obtained from these matings, 9 were affected with hyperkalemic periodic paralysis, and 6 were unaffected, consistent with an autosomal dominant mode of inheritance. Diagnosis was established by results of oral administration of potassium chloride and demonstration of characteristic clinical signs accompanied by hyperkalemia. Oral administration of potassium chloride resulted in marked increases in plasma potassium concentrations in affected and unaffected foals, although hyperkalemia was associated with clinical signs of hyperkalemic periodic paralysis in the affected foals. Evaluation of blood samples from affected and unaffected offspring revealed no linkage with erythrocyte and serum markers at 24 loci.

Animals↗
PubMed1995

[Surgical treatment of the bilateral abductor paralysis].

27 patients with bilateral vocal cord paralysis were treated in the First Clinical Medical College of Beijing Medical University, and all of them were followed up at least one year after treatment. According to the length of the vocal cord and the degree of the anterior angle of the thyroid cartilage, one of the three different surgical procedures would be selected to alleviate the symptoms of bilateral abductor paralysis. The width of glottic chink after treatment is the paramount index. The average estimated size of the posterior glottic chink or point of maximum width of glottic chink should be equal to or bigger than 4mm after surgical treatment. The open approach to arytenoidectomy-Woodman's Technique was performed in 15 patients, and among them the tracheal cannulas were removed in 11 cases, and 8 cases had a glottic chink bigger than 4mm width. In 9 cases with short length vocal cord and narrow anterior angle of the thyroid cartilage, a modified hemilaryngectomy was used by thyrotomical approach, and a successful result was obtained with good to excellent exercise tolerance for social activity. Unfortunately, in the remaining 3 patients, the nerve-muscle pedicle technique reinnervation of bilateral vocal cord paralysis was applied, and no patient demonstrated visible inspiratory vocal cord abduction. Although this type of operation might totally reconstruct respiratory function without phonation impairment, the clinical result was not certain.

Adolescent↗
PubMed1996

Tick paralysis--Washington, 1995.

Tick paralysis (tick toxicosis)--one of the eight most common tickborne diseases in the United States (1)--is an acute, ascending, flaccid motor paralysis that can be confused with Guillain-Barre syndrome, botulism, and myasthenia gravis. This report summarizes the results of the investigation of a case of tick paralysis in Washington.

Animals↗
PubMed1995

[Evaluation of acute flaccid paralysis (AFP) surveillance system in 1994].

Increased by 40.2% compared with 1993, 3142 acute flaccidparalysis cases were reported from AFP surveillance system in 1994. A total number of 1297 counties had AFP cases reported, accounting for 45.1% of total amount of counties. Out of 3142 AFP cases, 307 were confirmed, coming from 225 counties. For children under 15 years old, the reported AFP incidence was 1.1/10(5), non-polio AFP rate was 0.83/10(5), much higher than 0.37/10(5), in 1993. 48.5% of the total AFP cases had double stool specimen taken within 0-14 days after paralysis. 79% AFP cases had been investigated within 48 hours after being reported. Some of the major monitoring indicators of AFP surveillance system were close to the WHO criterion, but the percentage of AFP cases reported within 48 hours of careseeking and AFP cases with follow-up visit after 60-70 days of paralysis were very low. Furthermore, 77.9% of the confirmed cases were diagnosea clinically by residual paralysis, so did the 46.4% of discarded cases. It is in urgent need to increase the percentage of cases classified by laboratory test.

Acute Disease↗
PubMed1996

[Hypokalemic periodic paralysis: a rare presentation of thyrotoxicosis].

Hypokalemic periodic paralysis is an uncommon complication of thyrotoxicosis, and very rare as a presenting symptom. It is most frequent in east Asian and Japanese males, but extremely rare in others. Only 1 case has previously been reported from Israel. We present a 29-year-old Arab man who presented with sudden paralysis of both legs. Physical examination revealed signs of thyrotoxicosis, and laboratory tests showed profound hypokalemia. Oral potassium resulted in rapid disappearance of symptoms, and after restoration of the euthyroid state, there were no further attacks. This case shows that thyrotoxic hypokalemic periodic paralysis is not confined to males of east Asian and Japanese origin, and that adequate treatment with oral potassium and antithyroid drugs is successful, and should be given as soon as possible.

Adult↗
PubMed1995

Facial nerve paralysis following pediatric cardiac surgery.

A newborn female diagnosed with transposition of the great vessels with restrictive ventricular septal defect presented left facial peripheral nerve paralysis following anatomical surgery correction (arterial switch) by cardiopulmonary bypass. We have not found any causal factor either in the anesthesia or postoperative period. The electromyogram presented signs of peripheral nerve impairment, and the cerebral echography and electroencephalogram were normal. The facial nerve paralysis was almost recovered seven weeks after surgery. This is the first pediatric patient reported with peripheral facial nerve paralysis after cardiac surgery.

Facial Paralysis↗
PubMed1996

Vocal cord paralysis as an initial sign of multiple system atrophy in the central nervous system.

Multiple system atrophy (MSA) of the central nervous system has been recognized as a rare cause of stridor secondary to vocal cord paralysis. This respiratory problem usually occurs in the later stages of the disease. We report the case of a 53-year-old man who presented with bilateral vocal cord paralysis accompanied by stridor and sleep apnea, which were relieved by a tracheostomy. Two years after the onset of stridor, he developed extrapyramidal and cerebellar signs combined with severe autonomic failure. Magnetic resonance imaging of the brain revealed atrophy of the brainstem and cerebellum. This clinical picture is consistent with the diagnosis of MSA. Vocal cord paralysis preceding any other neurologic and autonomic manifestations has been infrequently described. This case should remind clinicians that MSA should be considered in the differential diagnosis of vocal cord palsy of undetermined origin.

Atrophy↗
PubMed1996

Seasonal dynamics of the Karoo paralysis tick (Ixodes rubicundus): a comparative study on Merino and Dorper sheep.

Karoo paralysis in South Africa is induced in livestock by feeding female Ixodes rubicundus ticks when infestation densities on hosts exceed certain critical levels. It has been shown previously that Angora goats are at a higher risk of being paralysed than Merino sheep, and such differences have been related to differences in feeding behaviour and spatial distribution of the two small-stock breeds. We hypothesized that differences in infestation densities with Karoo paralysis ticks would also occur between Merino and Dorper sheep breeds. A study was conducted under natural conditions in the south-western Free State, to compare infestation burdens of the two sheep breeds and also to investigate seasonal patterns and annual variations in variations in terms of rainfall and temperature. Ten animals of each breed ran free in an area with a known history of Karoo paralysis and were examined on an approximately fortnightly basis, from March 1992 to December 1995, to determine tick abundance. Differences between the two breeds were significant (P < 0.05) during 1992 and 1993, but not during 1994. During the first two years, peak abundance of ticks was reached earlier in Dorper than in Merino sheep, and it also reached higher levels in Dorper than in Merino sheep (mean = 17.9 and 7.3, respectively). In 1993, two Dorper, but no Merino sheep, were paralysed. Dorper sheep are clearly at a higher risk of being paralysed than are Merino sheep, and as such, they can serve as indicators of adult tick activity and hence of the time to commence prophylactic treatment. Differences between the two breeds are probably related to differences in grazing patterns. Marked variation in abundance and the time of onset of peak activity of I. rubicundus occurred over the years. Tick numbers were high in 1993 and 1995, but very low in 1992. In 1993, peak activity occurred earlier (April) than during the other years (June or July). These differences are related to differences in prevailing environmental conditions that influence tick activity in a complex manner. Heightened humidity and lower temperatures during the early stages of seasonal activity of the tick (April or May), normally result in peak abundance of ticks on hosts at that time.

Animals↗
PubMedDate not supplied

The origin of R2 of the blink reflex recorded on the affected side of patients with complete facial nerve paralysis.

The possible mechanisms contributing to the generation of R2-like response were investigated in 19 patients with complete facial nerve paralysis, where the efferent limb of the reflex arc is absent. The first possibility that potentials produced by the unaffected orbicularis oculi (0.0c) are conducted to the reference electrode taped over the nose was confirmed as the amplitude of R2 on the affected side was significantly reduced when the reference electrode was removed from the nose and taped on the ear lobule. The second possibility of volume conducted potentials produced by muscular generator in temporalis and masseter muscles through trigemino-trigeminal reflex was suggested in some patients based on three reproducible observations: (1) EMG activity of high amplitude could be recorded with electrodes taped over the affected 0.0c muscle during voluntary teeth clenching, (2) R2-like responses were recorded in patients with bilateral complete facial paralysis, (3) R2-like responses were recorded from temporalis and masseter muscles. The contribution of extraocular muscles could be discounted as R2 could be recorded from patients with Möbius's syndrome who had complete bilateral facio-ocular paralysis. The results of the present study further support the greater value of R1--rather than R2--in predicting clinical outcome of patients with peripheral facial nerve palsy.

Action Potentials↗
PubMed1975

Hyperkalemic periodic paralysis. Effects of potassium, exercise, glucose, and acetazolamide on blood chemistry.

Effects of strenous exercise, followed by rest, and of potassium administration on blood chemistry values were studied in two patients with hyperkalemic periodic paralysis and in normal volunteers. These procedures produced attacks of flaccid paralysis that occurred concomitantly with rapid rises in serum potassium concentrations and decreases in blood glucose and inorganic phosphate levels. With the exception of the serum potassium level which rose following exercise and potassium administration, there were no changes in the blood chemistry values of the normal volunteers. During the induced attacks of paralysis, the expired breath of the patients had a very strong odor of ketosis. Results of subsequent glucose tolerance tests were abnormal. Following 24 hour administration of acetazolamide, the studies were repeated. The drug appeared to cause lesser effects of stimuli on serum potassium levels and a stabilizing effect on blood glucose levels.

Acetazolamide↗