1/24. time constraints improve reaching movements in an ataxic patient.We report on a patient (AM) with a post-traumatic ataxia who has uncoordinated reaching movements to resting targets, but is able to catch moving objects. AM participated in three experiments to identify factors responsible for the favorable effect of object motion on her performance. In the first experiment, the task was to catch an object that moved away from AM. The speed of the object to be grasped (target object) varied. In experiment 2, the effect of time constraints on reaching performance was examined. AM had to reach for and grasp a stationary object and was allowed either 600 ms or 2000 ms to perform the task. In the third experiment, liquid crystal shutter glasses were used to manipulate the time that the subject was able to view the stationary target object and her reaching movements (vision-on time). While increased speed of the object, tighter time constraints, and short vision-on time hardly affected the performance of AM's unaffected left hand, they greatly improved her right-hand performance. These results are discussed in light of the hypothesis that the brain mechanisms controlling externally triggered movements differ from those controlling internally regulated movements.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/24. Some manoeuvres for releasing the hypertonus of spastic and shortened muscles.We describe some physiotherapeutic techniques and manoeuvres releasing the increased tone of spastic and shortened muscles. The techniques can be generally characterised and summed up into three groups as follows: I. First types of manoeuvres consists in setting up the extremity or segment into the position usually opposed or antagonistic to the limited direction. This position is held for several tens of seconds. After this, partial of the originally limited range of motion could be observed. A modification of this approach is effective for persistent extensor spasticity of the lower extremities. Extremity is taken up into the internal rotation and flexion of the hip joint, into the maximal flexion of knee joint and into dorsiflexion of ankle joint, and this position is held at least for 30 seconds. After this, the extensor spasticity is usually diminished and also the voluntary movements and gait pattern improved. II. Short active jerk (not exceeding 1/2 sec) in the free direction, alternatively against mild resistance, followed by 3-4 second release and slow stretch into the restricted range. It is essentially important that the initial jerk is as brisk as possible but performed with no special effort. In case the resistance is applied, it should be only slight. Then the therapist must grasp a "melting" of the hypertonus and cautiously guide the segment into the slow and gentle stretch. III. pressure stimulation of the particular active zones. The application of these manoeuvres and its combinations are demonstrated in case reports.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/24. Delayed and severe but transient tourette syndrome after head injury.A previously well and intellectually normal 7(1/2)-year-old girl developed an acute and severe tourette syndrome 15 months after sustaining a severe head injury. The patient displayed a dramatic response to haloperidol. Twelve months after the onset of tourette syndrome the haloperidol was withdrawn, and there was no relapse of either her motor or phonic tics. Seven years after the head injury the patient remains tic free but demonstrates significant emotional and behavioral sequelae. The patient's brain magnetic resonance imaging findings were consistent with those reported previously in adults with tourette syndrome.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/24. Neuropsychological testing following head injuries: prosopagnosia without visual field defect.Assessment of residual cerebral dysfunction in the post-traumatic patient poses considerable problems particularly when the neurological examination yields minimal or equivocal findings. The clinical picture is frequently complicated by emotional disturbance not easily differentiated from "post-traumatic neurosis." This report describes such a patient whose disorder was elicidated by neuropsychological testing. Numerous studies have established the validity of neuropsychological tests particularly when they are interpreted by psychologists specifically trained in their use. These procedures are also useful in differentiating patients with neurologic complaints of a nonorganic etiology from patients with similar complaints secondary to confirmed brain lesions. Although the findings reported here pertain to a patient exhibiting a rare neurologic consequence of closed head injury, the methods employed are applicable to subtle behavioral manifestations of diverse etiologies. Neurophyshological findings in a patient unable to recognize faces of familiar persons (prosopagnosia) disclosed a severe impairment of visual perception despite intact visual acuity and fields. The prosopagnosia was also associated with a pervasive memory deficit without dementia. Our results challenge current concepts of prosopagnosia and support the need for neuropsychological evaluation of post-traumatic patients.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/24. tinnitus in childhood.All of 1,420 children seen for clarification of a hearing disorder or to follow up for known difficulty in hearing were questioned as to whether they experienced tinnitus. The interview was carried out after a hearing test was conducted, which was based on play audiometry or normal pure-tone threshold audiometry, depending on the age of the child. When being interviewed, 102 children reported that tinnitus had appeared or was still present. Seventy-five children (73.5%) demonstrated difficulty in hearing in one or both ears, whereas 27 children (26.5%) had normal hearing in both ears. The most frequently obtained information (29.4%) was the progression of an existing hearing loss. meningitis is an important cause of hearing loss and of tinnitus and could be identified in 20% of our patients. We also considered as a cause of tinnitus skull or brain trauma, acute hearing loss, and stapes surgery. However, the mechanisms of tinnitus development were not immediately clear in a large proportion of the children studied: Problems included central sensory perception (14.7%) and emotional factors (11.8%). No additional information that might lead to an understanding of the hearing loss was available for 14.7% of the patients studied. tinnitus is a frequent symptom in childhood and, because children seldom complain about their tinnitus, such hearing problems that they report must always be taken seriously. The diagnosis should exclude metabolic disturbances, possible damage to the sensory level of the central nervous system, and circulatory disturbances. In addition, the physician should always consider emotional problems and disturbances of perception.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
6/24. Promoting continence following head injury.Assessment and identification of related problems are crucial in the management of incontinence and the promotion of continence. Assessment checklists and regular recording of incontinence using appropriate charts (toilet charting) help the nurse to diagnose the problems. It is not sufficient just to identify incontinence as the problem; assessment should be much more specific, e.g. identifying problems such as nocturia, nocturnal enuresis, urgency, urge incontinence and polyuria. Planning and implementing care should always promote the optimum level of continence as its final ideal goal. Appropriate and adequate management of any specific aspect/type of incontinence should be considered only if the ideal goal is unachievable. The tools and charts used for assessment are also useful in evaluating the effectiveness of care. Incontinence aids should be chosen only after careful assessment and should be used to lessen the specific problem and help promote continence. They should not be used to encourage continuing incontinence.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/24. Homicidal cerebral artery aneurysm rupture.When a normally natural mechanism of death is induced by physical injury or intense emotional stress, it is appropriate to rule the manner of death as something other than natural. When the case-specific circumstances are such that the death occurs as a result of the criminal activity of another person, it is acceptable to rule such deaths as homicides. Presented herein is a case of homicidal cerebral artery aneurysm rupture occuring in an intoxicated, 46-year-old man who was punched in the face by another individual. The details of the case are presented, followed by a discussion of the controversies that exist when dealing with such cases. Guidelines for investigating similar deaths are presented, with emphasis on the timing of the trauma in relation to onset of symptoms due to aneurysm rupture.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/24. Case report: whiplash-associated disorder from a low-velocity bumper car collision: history, evaluation, and surgery.STUDY DESIGN: Case report of a patient with a whiplash-associated disorder following a bumper car collision. Imaging studies failed to provide an anatomic explanation for the debilitating symptoms. OBJECTIVES: To report a chronic, debilitating pain syndrome after a low-velocity bumper car collision while using complex range-of-motion data for the diagnosis, prognosis, and surgical indication in whiplash-associated disorder. SUMMARY OF BACKGROUND DATA: The controversy of whiplash-associated disorder mainly concerns pathophysiology and collision dynamics. Although many investigations attempt to define a universal lesion or determine a threshold of force that may cause permanent injury, no consensus has been reached. methods: Eight years after a low-velocity collision, the patient underwent surgical excision of multiple painful trigger points in the posterior neck. Computerized motion analysis was used for pre- and postoperative evaluations. RESULTS: Surgical treatment resulted in an increase in total active range of motion by 20%, reduced intake of pain medication, doubled the number of work hours, and generally led to a dramatic improvement in quality of life. CONCLUSIONS: This case of whiplash-associated disorder after a low-velocity collision highlights the difficulty in defining threshold of injury in regard to velocity. It also illustrates the value of computerized motion analysis in confirming the diagnosis of whiplash-associated disorder and in the evaluation of prognosis and treatment.- - - - - - - - - - ranking = 4keywords = motion (Clic here for more details about this article) |
9/24. A human visual disorder resembling area V4 dysfunction in the monkey.We surveyed a broad range of visual functions in a man who complained of abnormal color experience and inability to recognize faces following bilateral damage in the visual cortex. A lesion in his right visual cortex caused complete left visual field loss. A lesion in his left visual cortex, located entirely below the calcarine fissure, affected the vision in his remaining hemifield, the right one. Psychophysical testing showed severely defective color vision and pattern processing, but relatively normal luminance contrast detection thresholds. The finding of normal spatial contrast sensitivity and static stereopsis did not resemble a parvocellular defect of the type described in the monkey. The abilities to detect global coherent motion among noise, structure from motion and dynamic stereopsis, and to pursue moving targets showed normal motion processing at several levels. Together with normal flicker perception, these results excluded magnocellular or MT-like defects. Altogether, the findings mimic area V4 dysfunction.- - - - - - - - - - ranking = 3keywords = motion (Clic here for more details about this article) |
10/24. Sudden traumatic death in children: "we did everything, but your child didn't survive".When caring for children who become suddenly and catastrophically ill, clinicians must simultaneously attend to a complex and rapidly evolving medical situation, as well as to the equally challenging demands of establishing compassionate relationships with family members and communicating well with colleagues. An 18-month-old toddler was brought to the hospital with severe head injury after being struck by a car. Over a period of hours, her condition evolved from prognostic uncertainty to the diagnosis of brain death and considerations of organ donation. Against this medical backdrop, the clinicians successfully established a trusting relationship with family members by careful attention to their emotional, informational, and care needs as they absorbed the devastating prognosis, took in the results of the brain death examination, and considered the option of organ donation. This case illustrates the importance of interdisciplinary communication, the vital role of social workers and other psychosocial providers with expertise in working with families, and the critical significance of mutual care and support for the clinicians who accompany families through these tragic life events.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
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