1/13. Complex spinal reflexes during transcranial Doppler ultrasound examination for the confirmation of brain death.OBJECTIVE: Complex sets of movements of the extremities can be seen in patients with brain death (BD), and are typically observed during apnea testing or removal of ventilatory support (also called the Lazarus sign). We here describe brain-dead patients who had not shown previous movements, even during apnea testing, but presented complex spinal reflexes during transcranial Doppler (TCD) examination elicited by neck flexion. methods: We performed a prospective TCD study of patients with the clinical diagnosis of BD. RESULTS: Four (2.5%) of 161 brain-dead patients presented complex spinal reflexes exclusively during TCD examination. TCD showed vertebro-basilar circulatory arrest in all four. Their systolic blood pressure was significantly lower than that of brain-dead patients not presenting movements during TCD examination. CONCLUSIONS: hypotension and mechanical stimulation play a role in the pathophysiology of complex spinal reflexes present in BD, which are not exclusively seen in terminal hypoxia. intensive care personnel and neurologists who perform TCD to confirm BD should be aware of these movements.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
2/13. Myokymic discharges: prompt cessation following nerve root decompression during spine surgery.In surgical cases during which spine nerve roots are at risk, we have found it useful to monitor EMG from the muscles supplied by those roots. Mechanical irritation of a root results in muscle activity, whose amplified signals can be broadcast over a loudspeaker, providing immediate feedback to the surgeon that the root is being irritated. We report here on a patient undergoing spinal canal decompression and fusion following a burst fracture of the L5 vertebral body sustained five days previously. EMG was continuously monitored from the tibialis anterior (TA) and medial gastrocnemius (MG) muscle groups bilaterally. During the period leading up to decompression, myokymic discharges from the left TA muscle were observed, whereas the other 3 muscles monitored did not show such activity. These semi-rhythmic and repetitive discharges from the left TA ceased immediately following surgical removal of a bone fragment compressing the left L5 nerve root. This indicates that the site of axonal irritation was the nerve root, and that myokymic discharges secondary to acute axonal compression can cease immediately upon nerve root decompression.- - - - - - - - - - ranking = 0.15478836141897keywords = spinal, canal (Clic here for more details about this article) |
3/13. Usefulness of transcervical approach for surgical treatment of hypoglossal schwannoma with paraspinal extension: case report.BACKGROUND: Usefulness of transcervical approach to hypoglossal schwannoma with paraspinal extension is described herein. CASE DESCRIPTION: A 54-year-old woman presented with gradually worsening left hypoglossal nerve palsy. The findings were of a tumor lying in the left hypoglossal canal and paraspinal region and were consistent with hypoglossal schwannoma. Subtotal intracapsular removal of the tumor was performed via transcervical approach. The symptoms improved, and no additional symptoms were noted. CONCLUSION: The transcervical approach and intracapsular removal of the tumor under electrophysiological monitoring provided for successful minimally invasive surgery in this case of hypoglossal schwannoma.- - - - - - - - - - ranking = 0.86907407570468keywords = spinal, canal (Clic here for more details about this article) |
4/13. exercise-induced myokymia with congenital spinal stenosis.myokymia and myokymic discharges are observed in a variety of neurologic conditions. An unusual case of myokymia induced by exercise and febrile illness presented in an 11-yr-old male with congenital spinal stenosis. myokymia was not generalized, but occurred below the level of his umbilicus. We hypothesize that local spinal cord ischemia was the underlying mechanism for this rare phenomenon. The pathophysiology, clinical features and electrodiagnostic findings of myokymia are reviewed.- - - - - - - - - - ranking = 0.85714285714286keywords = spinal (Clic here for more details about this article) |
5/13. Continuous muscle activity and distal spinal muscular atrophy.A young man presented with myokymias, cramp-like difficulty in muscle relaxation and peroneal atrophy. EMG studies revealed continuous muscle activity (CMA) manifested as grouped potentials and high frequency discharges. Sensory nerve conduction studies and sural nerve biopsy gave normal results, and he was thought to suffer from distal spinal muscular atrophy with CMA. This association suggests that the lower motor neuron may have an important role in the generation of the continuous muscle activity.- - - - - - - - - - ranking = 0.71428571428571keywords = spinal (Clic here for more details about this article) |
6/13. Distal ulnar neuropathy as a cause of finger tremor: a case report.A secretary/typist developed work-related pain along the hypothenar aspect of the dominant hand. This was later followed by involuntary, finally continuous tremorous movements of the 4th and 5th fingers. Electromyographic abnormalities were limited to myokymia of 3rd and 4th interossei muscles. Surgical decompression of Guyon's canal with removal of the pisiform bone resulted in a complete cure.- - - - - - - - - - ranking = 0.011931218561828keywords = canal (Clic here for more details about this article) |
7/13. Facial myokymia in syringobulbia.A patient with a 2-year history of progressive ataxia and tingling in the right hand had prominent facial myokymia. magnetic resonance imaging revealed syringomyelia and syringobulbia. After successful syringosubarachnoid shunting, the patient died of massive pulmonary embolism. Postmortem examination revealed a syrinx involving the spinal cord and lower half of the medulla; neither the facial nucleus nor facial nerve fibers were directly involved. We hypothesize that interruption of aberrant corticobulbar fibers in the medulla produced disinhibition of a rhythmic neural generator in the facial nucleus.- - - - - - - - - - ranking = 0.14285714285714keywords = spinal (Clic here for more details about this article) |
8/13. Neuromyotonia in the spinal form of charcot-marie-tooth disease.The term neuromyotonia has been applied to spontaneous activity of peripheral motor nerves which gives rise to pseudomyotonia, muscular fasciculations and myokymia. A family is described in which 8 members of 3 generations suffer from the spinal form of Charcto-Marie-Tooth disease (distal type of chronic spinal atrophy). 5 of the 8 members were examined and found to have myokymia, accentuated by voluntary muscle contraction. Pseudomyotonia was present in 2 patients and, in the 1 patient treated, was abolished by carbamazepine. The association between neuromyotonia and charcto-Marie-Tooth disease has been reported in only 7 patients before but may be more common than previously thought because muscle cramps are reported to be a feature of this disorder.- - - - - - - - - - ranking = 0.85714285714286keywords = spinal (Clic here for more details about this article) |
9/13. poliomyelitis-like illness after acute asthma (Hopkins syndrome): a histological study of biopsied muscle in a case.A case of Hopkins syndrome is presented. The patient was a 4-year-old boy who developed weakness of the right leg 2-3 days after a mild asthmatic attack. Needle electromyography revealed fasciculation discharges in the right gastrocnemius muscle. A histological study of the biopsied right quadriceps femoris muscle revealed scattered atrophic fibers, indicating lesions in the anterior horn cells of the spinal cord. This is the first reported case of Hopkins syndrome including muscle pathology.- - - - - - - - - - ranking = 0.14285714285714keywords = spinal (Clic here for more details about this article) |
10/13. Segmental fasciculations as a late sequel of spinal cord injury.In two patients with a history of spinal cord injury many years ago fasciculations developed in muscles belonging to previously damaged segments. In both patients MRI of the cervical spine showed an area of abnormal signal intensity representing a cavity, near the level of the neurological abnormalities and the cord injury. During a 4-year follow-up period no new neurological or MRI abnormalities were detected. A hypothesis for the genesis of fasciculations following spinal cord injury is presented.- - - - - - - - - - ranking = 0.85714285714286keywords = spinal (Clic here for more details about this article) |
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